Perforator flap breast reconstruction using internal mammary perforator branches as a recipient site: an anatomical and clinical analysis

Plastic and Reconstructive Surgery
Alexandre Mendonça MunhozMarcus Castro Ferreira

Abstract

A variety of useful recipient sites exist for breast reconstruction with free flaps, and correct selection remains a significant decision for the surgeon. Among the main pedicles, the disadvantages of the internal mammary vessels are the necessity of costal cartilage resection and the impairment of future cardiac bypass. This study was designed to reduce morbidity and to seek alternative recipient vessels. In the anatomical part of the study, 32 parasternal regions from 16 fresh cadavers were used. The locations and components of internal mammary perforator branches were measured and a histomorphometric analysis was performed. In the clinical part of the study, 36 patients underwent 38 deep inferior epigastric perforator (DIEP) flap and two superior gluteal artery perforator flap breast reconstructions (31 immediate and four bilateral). The recipient vessels were evaluated. In the anatomical study, there were 22 perforating vessels, with 14 (63.6 percent) on the second intercostal space and 11 (50 percent) with one artery and vein. The average (+/-SD) internal and external perforator artery diameters were 598.48 +/- 176.68 microm and 848.97 +/- 276.68 microm, respectively. In the clinical study, 13 successful anastomoses (32.5 ...Continue Reading

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Citations

Feb 18, 2014·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Fabio Santanelli di PompeoEnrico Cavalieri
Mar 26, 2016·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Anne C O'NeillStefan O P Hofer
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May 18, 2010·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Pascal P A SchellekensMoshe Kon
Jan 6, 2009·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Manfred SchmidtManfred Frey
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Jan 19, 2010·ANZ Journal of Surgery·N Gopalakrishna IyerBruce G Ashford
Mar 25, 2009·Microsurgery·Frank HölzleAndreas Wysluch
Feb 11, 2015·Journal of Plastic Surgery and Hand Surgery·Hosam Aboelatta, Yasser Abdallah Aboelatta
Jun 15, 2012·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Stefania TuinderRené Van Der Hulst
Aug 13, 2014·World Journal of Clinical Oncology·Alexandre Mendonça MunhozRolf Gemperli
May 15, 2007·Plastic and Reconstructive Surgery·Dan mon O'DeyNorbert Pallua
May 25, 2007·Annals of Plastic Surgery·Alexandre Mendonça Munhoz
Jun 19, 2007·Plastic and Reconstructive Surgery·Elisabeth K Beahm, Robert L Walton
Dec 20, 2007·Plastic and Reconstructive Surgery·Michel Saint-CyrPierre M Chevray
Dec 6, 2005·Plastic and Reconstructive Surgery·Alexandre Mendonça MunhozMarcus Castro Ferreira
Jul 3, 2008·Plastic and Reconstructive Surgery·Alexandre Mendonça Munhoz
Dec 3, 2009·Plastic and Reconstructive Surgery·Corrine WongRod J Rohrich
Oct 30, 2013·Plastic and Reconstructive Surgery·Benoit ChaputJean Louis Grolleau
Aug 13, 2015·Annals of the Royal College of Surgeons of England·J K DicksonS Wilson

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