Microsurgery: Transplantation and Replantation by Harry J. Buncke, MD, et al. |
C. The femoral artery is followed proximally until the superficial circumflex iliac (SCI) artery is found. The dissection continues proximally along the femoral artery. The inguinal ligament is retracted superiorly until the deep circumflex iliac (DCI) artery is encountered coming off the anterolateral, lateral, or posterolateral aspect of the external iliac artery, usually within 2 cm of the inguinal ligament. The deep inferior epigastric artery has its origin from the same region of the external iliac artery, only on the medial side. The venae comitantes of the deep circumflex iliac system are next isolated, first lateral to the external iliac vessels, then medially as they pass either superficially (50%) or deep (50%) to the external iliac artery to join the external iliac vein.
PLATE XV-3 A. Exposure is increased by cutting along the upper border of the flap, then down through the external oblique, internal oblique, and transversalis muscles. The island of skin should be tacked to the muscle cuff on the inner rim of the iliac crest to prevent shearing off the delicate perforators to the skin. |
PLATE XV-4 A. The inferior flap incision is made to expose the fascia lata. |
|
|||
Ch. 15 Page 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 |