MMSL 2019, 88(2):84-92 | DOI: 10.31482/mmsl.2019.005

THE ANGIOSOMAL CONCEPT:  AN OVERVIEW AND 3 ILLUSTRATIVE CASESCase report

Vanesa Lovětínská1*, Bohumil Zálešák2, Leo Klein ORCID...3,4, Adriana Brandejsová5
1 Department of Orthopaedic Trauma, 1st Faculty of Medicine, Charles University and Central Military University Hospital, Prague
2 Department of Plastic and Esthetic Surgery, Palacký University Teaching Hospital, Olomouc
3 Department of Surgery, Division of Plastic Surgery and Burns Treatment, Charles University Teaching Hospital, Hradec Králové
4 Department of Military Surgery, Faculty of Military Health Sciences, University of Defence, Hradec Králové
5 Department of Plastic Surgery, 3rd Faculty of Medicine, Charles University, Faculty Hospital Královské Vinohrady, Prague

The angiosomal theory and its clinical application is not the latest science discovery. Nevertheless, its importance in plastic reconstructive surgery is still often underestimated when planning surgical procedures. Knowing and understanding the main problem can be useful not only for planning the flap design but also for survival of large flaps and also the wound healing process. Learning more about the complexity of skin and soft tissue anatomy and the vasculatory system can be beneficial for a variety of medical subspecialities. The article is divided into two parts. Part one is an introduction to the history, anatomy and physiology of angiosomes and perforator flaps. The second part describes practical applications  in 3 various cases treated at the Department of Plastic and Esthetic Surgery, University Hospital Olomouc.

Keywords: angiosome; perforator; flap; delay phenomenon; choke and true anastomosis; chronic wound healing

Received: January 31, 2019; Accepted: April 8, 2019; Prepublished online: April 24, 2019; Published: June 7, 2019  Show citation

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Lovětínská, V., Zálešák, B., Klein, L., & Brandejsová, A. (2019). THE ANGIOSOMAL CONCEPT:  AN OVERVIEW AND 3 ILLUSTRATIVE CASES. MMSL, 88(2), 84-92. doi: 10.31482/mmsl.2019.005
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    References

    1. Taylor GI, Palmer JH, The vascular territories (angiosomes) of the body: experimental study and clinical applications. Br. J. Plast Surg. 40(2);1987:113-41. Go to original source... Go to PubMed...
    2. Hallock GG, Direct and indirect perforator flaps: The history and the controversy. Plast. Reconstr. Surg. 111;2003:855. Go to original source... Go to PubMed...
    3. Manchot C. The Cutaneous Arteries of the Human Body. New York: Springer-Verlag, 1983. Go to original source...
    4. Salmon M. Arteries of the Skin (edited by G. I. Taylor and M. Tempest). London: Churchill Livingstone, 1988.
    5. Cormac GC, Lamberty GH. The arterial anatomy of skin flaps. First edition. Edinburgh, London, Melbourne and New York: Churchill Livingstone, 1986.
    6. Dhar SC, Taylor GI. The delay phenomenon: the story unfolds. Plast. Reconstr. Surg. 1999;104(7):2079-91. Go to original source... Go to PubMed...
    7. Salmon M. Arteres de la Peau. Paris: Mason et Cie, 1936.
    8. Wang C., et al., An Overview of Pre-expanded Perforator Flaps: Part 1, Current Concepts., Clin. Plast Surg. 2017;44(1):1-11. Go to original source... Go to PubMed...
    9. Taylor GI. The angiosomes of the body and their supply to perforator flaps. Clin. Plast. Surg. 2003;30(3):331-342. Go to original source... Go to PubMed...
    10. Benedictine YC, Khor Price P. The comparative efficacy of angiosome-directed and indirect revascularisation strategies to aid healing of chronic foot wounds in patients with co-morbid diabetes mellitus and critical limb ischaemia: a literature review. Journal of Foot and Ankle Research, 2017.
    11. Mustapha JA, Diaz-Sandoval LJ, Saab F. Angiosome-Directed Therapy for the CLI Patient Case studies and the literature show the benefits of direct and indirect flow revascularization. Endovascular Today, 2014.
    12. Sumpio BE, Forsythe RO, Ziegler KR, van Baal JG, Lepantalo MJ, Hinchliffe RJ, Clinical implications of the angiosome model in peripheral vascular disease. J. Vasc. Surg. 58(3); 2013:814-26. Go to original source... Go to PubMed...
    13. Wolf KD et al. Free flap transplantation using an extracorporeal perfusion device: First three cases. J Craniomaxillofac Surg. 2016;44(2):148-54 Go to original source... Go to PubMed...
    14. Manchot C. Die Hautarterien des Menschlichen Körpers. Leipzig: F.C.W. Vogel, 1889.
    15. Calllegary PR, Taylor GI, Caddy CM, Minabe T. An anatomic review of the delay phenomenon: I. Experimental studies. Plast. Reconstr. Surg.: 1992;89(3):397-407. Go to original source... Go to PubMed...
    16. Taylor GI, Corlett RJ, Ashton MW. The Functional Angiosome: Clinical Implications of the Anatomical Concept. Plast Reconstr Surg. 2017;140(4):721-733. Go to original source... Go to PubMed...
    17. Morris SF, Taylor GI. The time sequence of the delay phenomenon: when is a surgical delay effective? An experimental study. Plast Reconstr Surg. 1995;95(3):526-33. Go to original source... Go to PubMed...
    18. Morris SF. Perforator flaps: A microsurgical innovation. Medscape J. Med. 2008;10(11):266.
    19. Daniel RK, Williams BH. The free transfer of skin flaps by microvascular anastomosis: An experimental study and reappraisal. Plast. Reconstr. Surg. 1973;52:16. Go to original source... Go to PubMed...
    20. Spalteholz W. Die Vertheilung der Blutgefässe in der Haut. Arch. Anat. Physiol.1893. Go to original source...
    21. Kohima I, Soeda S. Inferior epigastric artery skin flaps without rectus abdominis muscle. Br. J.Plast Surg. 1989;42(6):645-8. Go to original source... Go to PubMed...
    22. Taylor GI, Daniel RK. The anatomy of several free flap donor sites. Plast. Reconstr. Surg. 1975;56(3):243-53. Go to original source... Go to PubMed...
    23. Panse NS, Bhatt YC, Tandale MS. What Is Safe Limit of the Perforator Flap in Lower Extremity Reconstruction? Do We Have Answers Yet? Plast. Surg Int. 2011: 2011. p.349-357. Go to original source... Go to PubMed...
    24. Masia J, Clavero JA, Larranaga JR, Alomar X, Pons G, Serret P. Multidetector Row computed tomography in the planning of abdominal perforator flaps. J Plast Reconstr Aesthet Surg. 2006;59(6):594-599. Go to original source... Go to PubMed...
    25. Blondeel, Phillip N. M.D., et all, The "Gent" Consensus on Perforator Flap Terminology: Preliminary Definitions, Plast. Reconstr. Surg. 2003;112(5):1378-1383 Go to original source... Go to PubMed...

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