MORPHOLOGICAL AND FUNCTIONAL EVIDENCE, AND CLINICAL IMPORTANCE, OF VASCULAR ANASTOMOSES IN THE LATISSIMUS-DORSI MUSCLE OF THE SHEEP

Mobilisation of the latissimus dorsi muscle as a functional graft nece ssarily involves division of perforating arteries that enter the dista l portion of the muscle, rendering it vulnerable to ischaemic damage w hen the muscle is stimulated electrically. Using a fluorescent microsp here technique we showed that the blood flow contributed by the thorac odorsal artery decreases in a proximal-to-distal direction, and that o f the perforating arteries in a distal-to-proximal direction, but for neither does the flow decline to zero. This is consistent with earlier reports of anastomotic connections between the 2 arterial territories . We went on to use fluorescence microscopy to demonstrate the existen ce of these vascular anastomoses, the first such evidence obtained und er physiological conditions of pressure and how. In clinical applicati ons, the existence of anastomotic connections offers the prospect of m aintaining flow to the distal part of the grafted muscle without the d elays inherent in neovascularisation procedures.