A new lateral thoracic artery perforator flap design with multiple vascular territories in rats

Background To describe a new design for an extended lateral thoracic artery (LTA) perforator flap and investigate its anatomical, dynamic, and potential territories. Materials and methods To assess vascular territories, rats were randomized according to LTA perforator flap type into the surgical groups A, hemidorsal island flap; B, entire dorsal island flap; and C, reduced-size dorsal island flap. Results On postsurgical day 7, the surviving flap areas were 95%, 92%, and 89% in groups A, B, and C, respectively. Necrosis most commonly occurred in the contralateral LTA territories in groups B and C. The immunoreactivities of intercellular adhesion molecule 1 and vascular endothelial growth factor receptor 2 in dynamic territories, as choke vessel markers, were increased. Conclusions We clarified the LTA perforator flap nomenclature and defined its pedicle course and anastomosing patterns; furthermore, we demonstrated that the LTA perforator did not anastomose with its counterpart because of its unidirectional, oblique, and craniocaudal course. The LTA perforator flap was found to be a good model comprising multiple vascular territories and exhibiting continuous necrosis. © 2016 Elsevier Inc