Ideas and Innovations: Simplified Technique for Isolating

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Vascularized Rib Periosteal Grafts. Badran-Hassan-A. Safe-Ikram. El-Fayoumy-Saad. Plastic and Reconstructive Surgery. 1990 Dec. 86(6). pp 1208-1215. The fact that a revascularized rib graft can survive if its periosteal blood supply is maintained is now well documented *RF 1,2,3,4,5 *. Two approaches were described to obtain a rib periosteal segment, the anterior *RF 6,7,8 * and the posterolateral *RF 1,9,10 *. In a trial to protect the periosteal vessels to the ribs, a cuff that included the intercostal muscles and the pleura was often left attached to the harvested rib. Invariably this led to difficulty in the repair of the donor defect, with an associated high risk of pulmonary complications. This paper presents the results of an anatomic study of the periosteal circulation to the ribs in the costal groove segment. The information thus gained was used to clarify the role of inclusion of muscles and pleura with the harvested rib and to modify the posterolateral approach to avoid its complications.