Perfusion of the diep flaps: A systematic review with meta-analysis

Microsurgery
Kyeong-Tae Lee, Goo-Hyun Mun

Abstract

Perfusion zones of the deep inferior epigastric perforator (DIEP) flap aid surgeons in estimating approximate tissue territory with reliable perfusion. Since the Hartrampf perfusion zone was developed, it has been modified continuously; however controversies remain regarding whether the recent perfusion models can satisfy current anatomical and clinical evidence. We conducted a comprehensive review of previous studies to synthesize relevant knowledge and critically reappraise current perfusion models. All anatomical and clinical studies that investigated perfusion of DIEP flaps were searched, yielding 21 studies suitable for review. A meta-analysis was conducted when sufficient data were provided. The perforators had unpredictable subcutaneous courses and were preferentially directed laterally. The medial and lateral perforators showed different characteristics in terms of branching pattern, orientation, and linking vessels between them. Ex-vivo perfusion findings suggested that medial perforators favored Hartrampf zone II rather than zone III and perfused the entire abdomen frequently, whereas the lateral perforators favored zone III and their perfusion territories were limited primarily to the hemi-abdomen. In the meta-analys...Continue Reading

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Citations

Jul 25, 2019·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Di Wang, Wen Chen
Jun 17, 2020·Plastic and Reconstructive Surgery. Global Open·Daiki MoritaYoshio Moriguchi
May 24, 2020·Aesthetic Plastic Surgery·Harmeet BhullarWarren M Rozen
Jun 9, 2020·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Alexandra M AnkerSilvan M Klein
May 27, 2021·Plastic and Reconstructive Surgery. Global Open·Muiz A ChaudhryLouis de Weerd

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