Radiographic Study Evaluating Perforator Vessels in the Ischiorectal Fossa for Safe Elevation of Island Flaps

• Material Type: 博士論文
• Title: Radiographic Study Evaluating Perforator Vessels in the Ischiorectal Fossa for Safe Elevation of Island Flaps
• Author/Editor: Nagasaka, Shinji; Abe, Yoshiro; Yamashita, Yutaro; Yamasaki, Hiroyuki; Mineda, Kazuhide; Shimada, Mitsuo; Hashimoto, Ichiro
• Author Heading: Nagasaka, Shinji; Abe, Yoshiro; Yamashita, Yutaro; Yamasaki, Hiroyuki; Mineda, Kazuhide; Shimada, Mitsuo; Hashimoto, Ichiro
• Publication, Distribution, etc.: Wolters Kluwer Health|American Society of Plastic Surgeons
• Publication Date: 2022-10-11
• Publication Date (W3CDTF): 2022-10-11
• Alternative Title: 島状皮弁を安全に挙上するための坐骨直腸窩内穿通枝に関する放射線学的評価; Perforator Vessels in Ischiorectal Fossa
• Periodical title: Plastic and Reconstructive Surgery - Global Open
• No. or year of volume/issue: 10 10
• Volume: 10
• Issue: 10
• Pages: e4561-
• ISSN (Periodical Title): ISSN : 2169-7574
• Degree grantor/type: 徳島大学
• Date Granted: 2023-01-26
• Dissertation Number: 甲第3669号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: Radiographic Study; Perineal reconstruction; Perforator flaps; Ischiorectal Fossa; internal pudendal artery
• Target Audience: 一般
• Note (General): Background: Perforator flaps based on the ischiorectal fossa (IRF) (ie, internal pudendal artery perforator flaps) are useful for perineal reconstruction. The three-dimensional characterization of perforator arteries in the IRF remains unclear, as the IRF contains thick adipose tissue as well as organs, such as the rectum, vagina, and urethra. This study aimed to evaluate perforators in the IRF to guide the safe elevation of skin flaps designed based on the IRF. Methods: IRF vessels were examined in 200 bilateral computed tomography angiography scans performed in 100 patients. We examined branching patterns arising from the internal iliac artery and the origins of the skin perforators in the IRF. Results: The branching patterns of the internal iliac artery were divided into three groups: perforators derived exclusively from the internal pudendal artery (78%), perforators derived from the internal pudendal artery and the inferior gluteal artery (18%), and perforators derived exclusively from the inferior gluteal artery (4%). The average number of perforators in the IRF was 1.5 ± 0.7. The number of perforators was significantly higher in women than in men. The perforator arteries were found exclusively around the medial and dorsal sides of the ischial tuberosity. Conclusions: We found that perforators in the IRF were stable. All cases had more than one skin perforator, which was mainly derived from the internal pudendal artery. Although perforators cannot be identified during flap elevation because the fatty tissue in the IRF is very thick, physicians must focus on preserving the perforator-containing fatty tissue around the ischial tuberosity.
• Access Restrictions: インターネット公開
• Rights (production): This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
• Related Material (DOI): 10.1097/GOX.0000000000004561
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 徳島大学 : 徳島大学機関リポジトリ

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http://repo.lib.tokushima-u.ac.jp/files/public/11/118155/20230410114626860008/k3669_abstract.pdf fulltext

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