J Reconstr Microsurg 2008; 24(2): 093-094
DOI: 10.1055/s-2008-1076755
© Thieme Medical Publishers

A Method for Protecting the Anastomosis in Deep Inferior Epigastric Artery Perforator Flap Breast Reconstruction

Robert H. Caulfield1 , Garrick Georgeu1 , Niri S. Niranjan1
  • 1St. Andrew's Centre for Burns & Plastic Surgery, Broomfield Hospital, Chelmsford, United Kingdom
Further Information

Publication History

Publication Date:
25 April 2008 (online)

ABSTRACT

In cases of microvascular breast reconstruction with deep inferior epigastric artery perforator (DIEP) flaps, many authors often express concern about possible trauma to the microanastomosis from the suction drain routinely placed in the wound at the end of the case. The senior author has devised and practiced for many years a novel technique to protect the anastomosis from this potential trauma in breast reconstructions. This technique involves harvesting a “sleeve” of scarpa's fascia in the direction of the planned orientation and inset of the flap pedicle. In our experience, this technique is effective and robust, and we would like to recommend this to others for use in their DIEP flap reconstructions.

REFERENCES

  • 1 Granzow J W, Levine J L, Chiu E S, Allen R J. Breast reconstruction with the deep inferior epigastric perforator flap: history and an update on current technique.  J Plast Reconstr Aesthet Surg. 2006;  59 571-579
  • 2 Munhoz A M, Ishida L H, Montag E et al.. Perforator flap breast reconstruction using internal mammary perforator branches as a recipient site: an anatomical and clinical analysis.  Plast Reconstr Surg. 2004;  114 62-68
  • 3 Schoeller T, Wechselberger G, Roger J, Hussl H, Huemer G M. Management of infraumbilical vertical scars in DIEP flaps by crossover anastomosis.  J Plast Reconstr Aesthet Surg. 2007;  60 524-528
  • 4 Guzzetti T, Thione A. Successful breast reconstruction with a perforator to deep inferior epigastric perforator flap.  Ann Plast Surg. 2001;  46 641-643
  • 5 Tran N V, Buchel E W, Convery P A. Microvascular complications of DIEP flaps.  Plast Reconstr Surg. 2007;  119 1397-1405
  • 6 Gahankari D, Maylon A, Weiler-Mithoff E M. Avulsion of vascular anastomosis in free flap breast reconstruction.  Br J Plast Surg. 2001;  54 167-168

Robert H CaulfieldA.F.R.C.S.I. 

St. Andrew's Centre for Burns & Plastic Surgery, Broomfield Hospital

Chelmsford, Essex CM1 7ET, United Kingdom

    >