Surgical Anatomy of the Superficial Circumflex Iliac Artery Perforator Flap: An Anatomic Study of the Correlation of the Superficial and the Deep Branches of the Superficial Circumflex Iliac Artery and Evaluation of Perfusion from the Deep Branch to the Sartorius Muscle and the Iliac Bone

Background: Harvesting the sartorius muscle and the iliac bone with a superficial circumflex iliac artery (SCIA) perforator flap can be a challenging procedure. The aim of this study was to describe the anatomical topology of the deep branch of the SCIA in fresh cadavers, which has not been reported in detail. Methods: Twenty groin regions from 10 fresh cadavers were dissected. The characteristics and landmarks of the SCIA system, including branches to the sartorius muscle and the iliac bone, were examined. Perfusion of the sartorius muscle and the iliac bone via the deep branch of the SCIA was evaluated with indocyanine green angiography and computed tomography angiography. Results: The superficial and the deep branches were identifiable in all specimens. In 85% of the specimens, the bifurcation point could be seen within 2 cm from a fixed site (6 cm from the pubic tubercle to the anterior superior iliac spine (ASIS), and 3 cm caudal from that point). The deep branch in each case gave off branches to the sartorius muscle and the iliac bone. The cephalad portion of the sartorius muscle (up to 8 cm from the ASIS) and the superficial portion of the iliac bone (up to 1.5 cm from the iliac crest) were perfused by the deep branch of the SCIA. Conclusions: In all specimens, both the superficial branch and the deep branch of the SCIA were found. The deep branch was found consistently to give off perfusing branches to the sartorius muscle and the iliac bone. Prior Presentations: A part of this manuscript was presented at the 2018 Annual Meeting of the American Society of Reconstructive Microsurgery. Disclaimers and Disclosure of Conflicts of Interest: None. Funding: None. Conflicts of Interest: None declared. Corresponding Author: Hidehiko Yoshimatsu, M.D. , Address: Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550 Japan. Tel.: +81 3 3520 0111; fax: +81 3 3520 0141. E-mail: hidehiko.yoshimatsu@gmail.com ©2018American Society of Plastic Surgeons

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