Deep inferior epigastric artery perforator flap harvest after full abdominoplasty

Acta chirurgica Belgica
Assaf A ZeltzerM Hamdi

Abstract

Abdominal scars are no longer a contra-indication for abdominal perforator flap harvesting. Few research data exists about the regeneration potential of the abdominal wall's perforator system. Therefore, previous abdominoplasty with umbilical transposition is an absolute contra-indication for a DIEaP-flap (deep inferior epigastric artery perforator flap). A 50-year-old patient required a breast reconstruction of the right breast, 10 years after an abdominoplasty with undermining of the superior abdomen and umbilical transposition. The patient was scheduled for a free lumbar artery perforator (LaP) flap. The preoperative computed tomography-angiography mapping showed nice lumbar perforators and to our surprise a good-sized DIEa perforator in the peri-umbilical region. The DIEa perforator on the right hemi-abdomen, consisting of two veins and one artery, was pulsatile and found suitable in size. A classical flap harvest and transfer was further performed. This case report is the first in which a dominant perforator is found in the area of undermining after a full abdominoplasty with umbilical repositioning. Further investigations regarding the nature and timing of re-permeation or regeneration of perforators after abdominoplasty ...Continue Reading

References

Nov 17, 2001·Plastic and Reconstructive Surgery·D RibuffoN Scuderi
May 6, 2008·Plastic and Reconstructive Surgery·Brian M ParrettBernard T Lee
May 28, 2011·Plastic and Reconstructive Surgery·Assaf A ZeltzerKoenraad Van Landuyt
Dec 21, 2011·Plastic and Reconstructive Surgery·Ajay L MahajanMoustapha Hamdi
May 1, 2012·Plastic and Reconstructive Surgery·Justin M BroylesGedge D Rosson
Oct 26, 2012·Plastic and Reconstructive Surgery·Warren M Rozen, Rafael Acosta
Nov 28, 2013·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Moustapha HamdiAssaf Zeltzer

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