Thoracoacromial artery and vein as main recipient vessels in deep inferior epigastric artery perforator (DIEP) flap transfer for breast reconstruction

2021 ◽  
Vol 123 (5) ◽  
pp. 1232-1237
Author(s):  
Takumi Yamamoto ◽  
Takashi Kageyama ◽  
Hayahito Sakai ◽  
Yuma Fuse ◽  
Reiko Tsukuura ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Diep Flap ◽  
Inferior Epigastric Artery ◽  
Flap Transfer ◽  
Thoracoacromial Artery ◽  
Epigastric Artery ◽  
Deep Inferior Epigastric Artery ◽  
Artery Perforator

scholarly journals Does surgical procedure type impact postoperative pain and recovery in deep inferior epigastric artery perforator flap breast reconstruction?

2020 ◽  
Vol 47 (4) ◽  
pp. 324-332
Author(s):  
Alexander A. Azizi ◽  
Anita T. Mohan ◽  
Taj Tomouk ◽  
Elizabeth B. Brickley ◽  
Charles M. Malata
Keyword(s):  
Postoperative Pain ◽  
Breast Reconstruction ◽  
Hospital Stay ◽  
Diep Flap ◽  
Inferior Epigastric Artery ◽  
Epigastric Artery ◽  
Significant Difference ◽  
Deep Inferior Epigastric Artery ◽  
Postoperative Morphine ◽  
Artery Perforator

Background The deep inferior epigastric artery perforator (DIEP) flap is the commonest flap used for breast reconstruction after mastectomy. It is performed as a unilateral (based on one [unipedicled] or two [bipedicled] vascular pedicles) or bilateral procedure following unilateral or bilateral mastectomies. No previous studies have comprehensively analyzed analgesia requirements and hospital stay of these three forms of surgical reconstruction.Methods A 7-year retrospective cohort study (2008–2015) of a single-surgeon’s DIEP-patients was conducted. Patient-reported pain scores, patient-controlled morphine requirements and recovery times were compared using non-parametric statistics and multivariable regression.Results The study included 135 participants: unilateral unipedicled (n=84), unilateral bipedicled (n=24) and bilateral unipedicled (n=27). Univariate comparison of the three DIEP types showed a significant difference in 12-hour postoperative morphine requirements (P=0.020); bipedicled unilateral patients used significantly less morphine than unipedicled (unilateral) patients at 12 (P=0.005), 24 (P=0.020), and 48 (P=0.046) hours. Multivariable regression comparing these two groups revealed that both reconstruction type and smoking status were significant predictors for 12-hour postoperative morphine usage (P=0.038 and P=0.049, respectively), but only smoking, remained significant at 24 (P=0.010) and 48 (P=0.010) hours. Bilateral reconstruction patients’ mean hospital stay was 2 days longer than either unilateral reconstruction (P<0.001).Conclusions Although all three forms of DIEP flap breast reconstruction had similar postoperative pain measures, a novel finding of our study was that bipedicled DIEP flap harvest might be associated with lower early postoperative morphine requirements. Bilateral and bipedicled procedures in appropriate patients might therefore be undertaken without significantly increased pain/morbidity compared to unilateral unipedicled reconstructions.

Deep Inferior Epigastric Artery Perforator Flap Breast Reconstruction in Patients With Previous Bariatric Surgery

2016 ◽  
Vol 76 (2) ◽  
pp. 216-220 ◽  
Author(s):  
Carlos A. Martinez ◽  
Jules A. Walters ◽  
Erika A. Sato ◽  
Jason J. Hall ◽  
Sean G. Boutros
Keyword(s):  
Bariatric Surgery ◽  
Breast Reconstruction ◽  
Perforator Flap ◽  
Inferior Epigastric Artery ◽  
Epigastric Artery ◽  
Deep Inferior Epigastric Artery ◽  
Artery Perforator
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