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Biomedical subjects

Steven F Morris

Publications and source records attributed to Steven F Morris.

6 recordsLinked to original sources
PubMed2003

Reversed forearm island flap supplied by the septocutaneous perforator of the radial artery: anatomical basis and clinical applications.

The cutaneous perforators of the radial artery adjacent to the superficial branch of the radial nerve and the lateral antebrachial cutaneous nerve were investigated, and the vascular anatomical features of the reversed forearm island flap supplied by those accompanying perforators were documented. Ten fresh cadavers were systemically injected with lead oxide, gelatin, and water. Twenty forearms were then dissected, and an overall map of the cutaneous vasculature and source vessels was constructed. The accompanying arteries were observed to lie along the lateral antebrachial cutaneous nerve and the superficial branch of the radial nerve and to nourish the skin through cutaneous branches. Vascular communication among these cutaneous vessels was evaluated, to determine the cutaneous vascular territory of the radial forearm flap. This anatomical information facilitates flap design in the forearm region. Clinical experience regarding the usefulness of the reversed forearm island flap for hand reconstruction for a series of five patients is presented.

Adult↗
PubMed2003

Perforator flaps: evolution, classification, and applications.

In this article, the authors review the literature regarding perforator flaps. Musculocutaneous perforator flaps have evolved from musculocutaneous flaps and offer several distinct advantages. By sparing muscle tissue, thus reducing donor site morbidity and functional loss, perforator flaps are indicated for a number of clinical problems. The versatility of the perforator flap makes it ideal for the reconstruction of three-dimensional defects such as breast reconstruction or as a thin flap for resurfacing shallow wounds when bulk is considered a disadvantage. The authors review the historical development of the perforator flap and discuss the advantages and disadvantages of perforator flaps compared with free and pedicled musculocutaneous flaps. The nomenclature traditionally used for perforator flaps is confusing and lacks a standardized anatomic basis. The authors present a method to describe all perforator flaps according to their artery of origin.

Humans↗
PubMed2003

Cutaneous vasculature of the forearm.

Five fresh human cadavers were injected with lead oxide, gelatin, and water. Nine forearms were dissected and an overall map of the cutaneous vasculature by source vessel was constructed. The average number of arterial perforators per source vessel was calculated. The forearm was then divided into three regions, and the density of perforators per region was calculated and compared. The overall number of arterial perforators decreases from proximal to distal in the forearm, but the overall density of perforators 0.5 mm or larger remains uniform. It was observed that the distal third of the forearm has a rich supply of smaller caliber arterial perforators compared with the proximal two-thirds of the forearm. The angiographic studies demonstrate a series of arterial perforators arising from the radial and ulnar arteries. The perforators in turn are linked longitudinally with other perforators from the same source vessel and transversely with the other major vessel. An understanding of this pattern of arterial supply of the forearm integument is helpful for the design of pedicled skin flaps and perforator flaps in the forearm.

Forearm↗
PubMed2003

Variability in the vascularity of the pectoralis major muscle.

OBJECTIVE: Although the pectoralis major muscle has been the subject of numerous anatomic studies over the past 20 years, there remains a high complication rate for pedicled pectoralis musculocutaneous flaps. In this report, angiograms of 43 pectoralis major muscles were studied to assess the vascular territories of its three arterial supplies: lateral thoracic artery, the pectoral branch of the thoracoacromial artery, and the anterior intercostal perforators of the internal mammary artery. METHODS: Twenty-two adult human cadavers underwent whole-body arterial perfusion (200 mL/kg) with a mixture of lead oxide, gelatin, and water through the carotid artery. All pectoralis major muscles were dissected and radiographed. Radiographs were photographically printed as contact prints. The vasculature of each muscle was analyzed using the paper template technique. RESULTS: The pectoral branch of the thoracoacromial artery supplied 50.7% of the vascular territory of the pectoralis major. The lateral thoracic artery was present in 37 of 43 angiograms and supplied a mean territory of 6.6%. The anterior intercostal perforating branches of the internal mammary artery supplied 43% of muscle parenchyma. There was considerable variability in the extent of various vascular territories from muscle specimen to specimen. CONCLUSION: Despite excellent surgical technique, certain pedicled musculocutaneous pectoralis major flaps may suffer partial distal necrosis simply owing to the relatively small vascular territory of the pectoral branch of the thoracoacromial artery.

Adult↗
PubMed2002

Reversed sural island flap supplied by the lower septocutaneous perforator of the peroneal artery.

The current study was conducted to document the vascular anatomy of the distally based superficial sural artery flap and to study the vascular anastomoses between the superficial sural artery and the septocutaneous perforator of the peroneal artery. Five fresh human cadavers were injected with lead oxide, gelatin, and water. Ten legs were then dissected and an overall map of the cutaneous vasculature by source vessel was constructed. Vascular communication between the superficial sural artery and the lowest septocutaneous perforator of the peroneal artery was evaluated to determine the cutaneous vascular territory of the superficial sural flap. This anatomic information enhances our understanding of flap design. The authors' clinical experience with the usefulness of the distally based island flap as a method of reconstruction in the lower leg and foot in a series of 26 patients is presented.

Adult↗