Two Cases of the Vascular Territory of a Single-pedicled Deep Inferior Epigastric Perforator Flap with a Vertical Midline Abdominal Scar

Plastic and Reconstructive Surgery. Global Open
Daiki MoritaYoshio Moriguchi

Abstract

: The deep inferior epigastric perforator (DIEP) flap is becoming the gold standard for breast reconstruction using autologous tissue. If there are scars in the abdomen from previous surgery, it is necessary to judge the indication for using this flap carefully. Particularly in cases with vertical midline scars, the blood flow supply to the zone II can be compromised. Even when patients have a median abdominal scar, it has been reported that the blood flow can extend beyond the scar and reach several centimeters to about half of zone II. We performed breast reconstruction using DIEP flaps for 2 patients with vertical midline scars in the lower abdomen. Indocyanine green angiography was conducted intraoperatively to confirm the vascular territory with a single pedicle before cutting off the flap. One patient showed fluorescence contrast on the contralateral side across the midline scar. However, the fluorescence contrast was absent across the midline scar in the other patient. Based on this result, we investigated the possible vascular territory of a single pedicled DIEP flap in patients with vertical midline abdominal scars. We suggest that successful blood supply to zone II of a single-pedicled DIEP flap in a patient with a ve...Continue Reading

References

Sep 6, 2005·Plastic and Reconstructive Surgery·Lior HellerDavid W Chang
Nov 28, 2008·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Frank HsiehCharles M Malata
May 5, 2011·Annals of Plastic Surgery·Steven L HenryMing-Huei Cheng
Mar 30, 2012·Plastic and Reconstructive Surgery·Albert LoskenGrant W Carlson
Jul 9, 2014·Annals of Plastic Surgery·Chang-Cheng ChangMing-Huei Cheng
Feb 11, 2015·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Alexis T LaunganiMichel Saint-Cyr
Aug 4, 2015·Microsurgery·Rosaria LaportaFabio Santanelli di Pompeo
Jan 17, 2016·Microsurgery·Kyeong-Tae Lee, Goo-Hyun Mun

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Methods Mentioned

BETA
cesarean section
fluorescence imaging

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