Background: With a new era of flap surgery, additional anatomical information is required. The relatively recent interest in musculocutaneous perforator flaps has once again sparked interest in the vascular anatomy of surgical flaps. There are a variety of anatomical techniques available to define the vascular anatomy of tissues of interest. In this article, the authors review vascular injection techniques available and describe the technique currently used in their laboratory.
Methods: A comprehensive review of vascular injection techniques is summarized. Barium sulfate and lead oxide in particular are reviewed in detail.
Results: This article reviews the historical development of vascular injection techniques, outlines current investigative methods, and expands on a radiopaque lead oxide and gelatin injection method that provides high-quality angiograms.
Conclusions: The standard method for the study of perforator flap is the lead oxide-gelatin technique. However, other methods can provide complementary information on vascular anatomy.