Baian Lai; XingYan Liu; Junxi Wu; Xiaohan Shi & Shengbo Yang

Our team has modified Sihler's intramuscular nerve staining method to allow for calculation of nerve density. Therefore, this study aimed to show the overall distribution pattern of the thoracic cutaneous nerves to provide a morphological basis for selecting and matching sensory reconstruction during skin flap transplantation. Twelve Chinese adult cadavers were dissected; the thoracic skin was removed, and the modified Sihler's staining method was performed. Centered around the nipple, the chest skin was divided into four regions: medial-superior, lateral-superior, lateral-inferior, and medial-inferior. The thoracic skin was not only innervated by the branches of the 1st to 7th intercostal and supraclavicular nerves, but also by a small number of nerves that directly reached the skin and passed through the pectoralis major muscle. There is a phenomenon of cross overlap between the branches of adjacent intercostal nerves. The branches of the 2nd to 7th intercostal nerves were distributed in the breast, and the branches of the lateral and anterior cutaneous branches were densely distributed around the nipple, forming a grid-like anastomosis. There was no cross-overlapping innervation between the anterior cutaneous branches on both sides. The density of nerve distribution in the four regions of the chest was in the order of the medial-superior, lateral-superior, lateral-inferior and medial-inferior region, respectively. These results may be used to map sensory regions when designing thoracic skin flaps for reconstruction surgery to obtain improved sensory recovery.

KEY WORDS: Thoracic cutaneous nerves; Distribution pattern; Sensory reconstruction; Sihler's stain.

LAI, B.; LIU, X.Y.; WU, J.; SHI, X. & YANG, S. Sihler's staining of the thoracic cutaneous nerve and its significance. Int. J. Morphol., 42(4):954-959, 2024.