Clin Surg | Volume 1, Issue 1 | Research Article | Open Access

The Anatomical Basis of the Lumbar Artery Perforator Flap: A Cadaveric and Computer Tomography Angiogram Study

Lorenzo Calì€-Cassi1*, Shai M. Rozen2, Maria Mani1, Thorir Audolfsson1, Gangadasu Reddy2 and Andres Rodriguez-Lorenzo1

1Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, Sweden
2Department of Plastic Surgery, UT Southwestern Medical Center, USA

*Correspondance to: Lorenzo Cali Cassi 

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Background: Lumbar skin flaps based on cutaneous perforators arising from the lumbar artery have been described for coverage of lumbosacral defects and as free flaps for autologous breast reconstruction. Thus, the purpose of this study is to clarify anatomical aspects of the lumbar artery perforator flaps pertaining improvement in utility and design of this flap.Methods: Five fresh human bodies were dissected and twenty three-dimensional computed tomographic (CT) angiographic previously used for the evaluation of the deep inferior epigastric perforator flap in patients that underwent breast reconstruction were evaluated. All cutaneous lumbar artery perforators were analyzed for total number, location, and external diameter.Results: The number of perforators observed per side was 1.6±0.84 in the CT angiography and 3±1.05 in the cadaver study. Data from CT angiographies showed a mean diameter of the pedicle of 2.76±0.74 mm. This perforators were located at the mean distance from the midline (spinal process) of 76.56±6.97 mm, the mean length pedicle were 19.88±7.57 mm. Data from the cadaveric dissection study the mean diameter of the pedicle were 1.96±0.57 mm, the mean distance from the midline were 69.6±22.5 mm.Conclusion: The lumbar artery perforator flap is based on a perforator that has a predictable location and presents a good caliber. Versatility of design of a pedicled flap as a propeller, bilobed or transposition flap based on this reliable perforator can be useful to reconstruct complex defects in the lumbar area. Preoperative planning with CT angiography is recommended to assess the location and caliber of the perforator allowing a better design of the flap.


Lumbar artery perforator flap; Computed tomography; Cadaveric


Cali-Cassi L, Rozen SM, Mani M, Audolfsson T, Reddy G, Rodriguez-Lorenzo A. The Anatomical Basis of the Lumbar Artery Perforator Flap: A Cadaveric and Computer Tomography Angiogram Study. Clin Surg. 2016; 1: 1270.

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