Dominance between angiosome and perforator territories: A new anatomical model for the design of perforator flaps

Abstract

An understanding of the angiosome of a source vessel in supply to a perforator flap is essential to flap design. With substantial interindividual variability in the size and reliability of such territories, preoperative awareness of factors that affect the number or size of perforators in a given territory can aid operative planning. Body weight and scarring are known to modify a given territory, and anecdotally so too can the dominance of adjacent vascular territories. A clinical study of 300 patients (600 body sides) was undertaken, using computed tomographic angiography, to map the vessels of six vascular territories. The effect of interplay between vascular territories was assessed by es..