Flaps have become an integral part of plastic and reconstructive surgery. The robust blood supply of such flaps is a prerequisite to reduce flap failure. Despite the reported versatility of the occipital flap, comprehensive anatomical studies on its perforators and perforasomes are lacking. Hence, we examined the perforators originating from the occipital artery and their associated perforasomes, aiming to fill this knowledge gap for reconstructive surgery techniques. 39 of 40 occipital arteries of 20 fresh anatomical head specimens were dissected. Perforators with a least an outer diameter of 0.50 mm were identified and injected with dye to color their respective perforasomes. Location and size of the colored skin areas were determined as well as the location of their perforators were documented and analyzed. In total, 183 perforators were found and described. The mean diameter of these vessels was 0.88 ± 0.27 mm (0.5–2.1 mm). The mean area of the perforasomes was 1288.26 ± 662.51 mm (144.60–3890.60 mm). They were localized over the whole nuchal and occipital area. Lastly, perforator diameters were significantly associated with the size of their resulting perforasomes. This study is the first comprehensive overview of perforators and associated perforasomes of the occipital artery on a respectable amount of specimen. The arterial supply of big portions of the occipital and nuchal area is provided solely by the perforators of the occipital artery. For flap surgery, perforator diameter is a crucial detail to be considered in the decision-making process.

中文翻译：

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枕动脉穿支和穿孔体的首次标准化评估——解剖学研究

皮瓣已成为整形和重建手术不可或缺的一部分。此类皮瓣的强大血液供应是减少皮瓣失败的先决条件。尽管据报道枕叶皮瓣具有多功能性，但仍缺乏对其穿支和穿孔体的全面解剖学研究。因此，我们检查了源自枕动脉的穿支及其相关的穿孔体，旨在填补重建手术技术的知识空白。解剖了 20 个新鲜头部解剖标本的 40 条枕动脉中的 39 条。确定外径至少为 0.50 mm 的穿孔器，并注入染料以对其各自的穿孔体进行着色。确定了有色皮肤区域的位置和大小，并记录和分析了其穿孔器的位置。总共发现并描述了 183 个穿支。这些血管的平均直径为 0.88 ± 0.27 毫米（0.5–2.1 毫米）。穿孔体的平均面积为 1288.26 ± 662.51 mm (144.60–3890.60 mm)。它们分布在整个颈项和枕骨区域。最后，穿支直径与其产生的穿孔体的大小显着相关。这项研究是对大量标本上枕动脉穿支和相关穿孔体的首次全面概述。枕骨和项部区域大部分的动脉供应仅由枕动脉的穿支提供。对于皮瓣手术，穿支直径是决策过程中需要考虑的关键细节。