Limiting the fascia incision length in a DIEP flap: repercussion on abdominal wall morbidity

2021 ◽  
Author(s):  
Paulien H Hilven ◽  
Marc Vandevoort ◽  
Frans Bruyninckx ◽  
Randy De Baerdemaeker ◽  
Yamina Dupont ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Diep Flap ◽  
Incision Length

OPTIMIZATION IN DIEP FLAP BREAST RECONSTRUCTION (DEEP INFERIOR EPIGASTRIC ARTERY PERFORATOR FLAP) WITH THE HELP OF CT(A) AND 3D MAPPING

2019 ◽  
Vol 65 (4) ◽  
pp. 603-607
Author(s):  
R. Pesotskiy ◽  
P. Kalinin ◽  
Petr Krivorotko ◽  
Andrey Mishchenko ◽  
Konstantin Zernov ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Abdominal Wall ◽  
Ct Angiography ◽  
Anterior Abdominal Wall ◽  
Tissue Injury ◽  
Perforator Flap ◽  
Operation Time ◽  
Diep Flap ◽  
Preoperative Preparation ◽  
Aesthetic Result

Introduction: deep inferior epigastric perforator flap (DIEP-flap) reconstruction provides the most acceptable aesthetic result among autologous breast reconstruction. However, a thorough preoperative assessment of the individual vascular anatomy of the deep lower epigastric vessels (DIEA/V) is still challlenging. Usage of CT(a) allows define individual anatomical features such as: intramuscular stroke, tortuosity of vessels and their branches which is an essential thing for reducing of the operation time, flap ischemia time, decreasing the complication rate. Material and methods: with the help of Radiology Department, we have launched a new protocol for planning of the DIEP flap surgery. As a preoperative preparation, we perform CT angiography (CTA) according to a specific protocol, which allows us to reduce the trauma of aponeurosis and the rectus abdominis muscle. Сonclusion: preoperative CT angiography, performed according to a special scanning and post-processing protocol, allows us to optimize the planning of the surgical intervention and improving the results of breast reconstruction. Detailed study of the topography of the vessels of the anterior abdominal wall leads to a decrease in tissue injury of the anterior abdominal wall. This article describes the importance of CT angiography, for the preoperative preparation (visualization) as a crucial step in preparing for the DIEP reconstruction of the breast.

scholarly journals Infrared Thermography for DIEP Flap Breast Reconstruction Part I: Measurements †

Proceedings ◽  
2019 ◽  
Vol 27 (1) ◽  
pp. 48 ◽  
Author(s):  
Steenackers ◽  
Verstockt ◽  
Cloostermans ◽  
Thiessen ◽  
Ribbens ◽  
...  
Keyword(s):  
Blood Flow ◽  
Blood Vessel ◽  
Breast Reconstruction ◽  
Abdominal Wall ◽  
Infrared Thermography ◽  
Diep Flap ◽  
Flap Reconstruction ◽  
Ir Thermography ◽  
Helpful Tool ◽  
Made In

In order to identify the exact location of a useful perforator for DIEP flap breast reconstruction, CT images are made in the pre-operative phase. The aim of this research is to evaluate if dynamic infrared thermography is a helpful tool to check and visualize the blood flow in the flap during the pre- and peroperative phase. The results will be used in order to pinpoint the usefulness of IR thermography as an alternative method for perforator mapping and flapdesign. By means of infrared thermography the blood vessel distribution and its vascularisation of the abdominal wall will be visualized. The thermal images can help to detect the correct perforator and can help to decide which parts of the flap are best perfused and can be used for the DIEP flap reconstruction.

High-Frequency Ultrasound: A Useful Tool for Evaluating the Abdominal Wall following Free TRAM and DIEP Flap Surgery

2006 ◽  
Vol 117 (4) ◽  
pp. 1113-1120 ◽  
Author(s):  
Toni Zhong ◽  
Aili Lao ◽  
Melanie S. Werstein ◽  
Donal B. Downey ◽  
H Brian Evans
Keyword(s):  
Abdominal Wall ◽  
High Frequency ◽  
Diep Flap ◽  
High Frequency Ultrasound ◽  
Flap Surgery ◽  
Wall Following ◽  
Frequency Ultrasound

Clinical Outcome of Abdominal Wall after DIEP Flap Harvesting and Immediate Application of Abdominoplasty Techniques

2005 ◽  
Vol 116 (7) ◽  
pp. 1881-1893 ◽  
Author(s):  
Alexandre Mendon??a Munhoz ◽  
Gustavo Sturtz ◽  
Eduardo Montag ◽  
Eduardo Gustavo Arruda ◽  
Cl??udia Aldrighi ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Abdominal Wall ◽  
Diep Flap

scholarly journals The Choice of Abdominal Flap Used in Breast Reconstruction Surgery

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
James McVeigh ◽  
Peter Kalu
Keyword(s):  
Breast Cancer ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Diep Flap ◽  
Tram Flap ◽  
Recipient Site ◽  
Rectus Abdominus ◽  
Free Flap Surgery ◽  
National Breast ◽  
Muscle Sparing

The incidence of breast cancer has been progressively increasing to the current level where 1 in 8 women now develop the disease. The National Breast Screening Programme has enabled us to diagnose many breast cancers at a much earlier stage. Coupled with an improved understanding of the oncoplastic approach to breast cancer surgery, genomics, hormone and targeted therapies as well as chemotherapy we now anticipate better outcomes. Despite the many advances in breast cancer there remains a significant cohort of women who are diagnosed with advanced forms of the disease that necessitates mastectomy i.e. the removal of all breast tissue. For many, reconstruction maybe immediately possible at the same time as mastectomy using either non-autologous (man-made) options such as breast implants and tissue expanders or autologous options using the latissimus-dorsi, abdominal or non-abdominal based flaps sited on thigh, buttock or lower flank tissue. Abdominal based reconstructions have evolved from crude operative procedures in which large parts of the lower anterior abdominal wall were harvested while remaining attached to the feeding vascular supply. This ‘flap’ of tissue is then rotated upon the pedicle of vessels into the new location in the breast. Pedicled Transverse Rectus Abdominus Myocutaneous (TRAM) flaps were often complicated by under-perfusion of the transferred flap resulting in fat necrosis. There were also issues with abdominal wall bulges and hernias as a result of the loss of the rectus abdominus muscle. With improvements in microsurgery the advent of free flap surgery was ushered in. Skin and fat were transplanted from the lower anterior abdominal wall using one of the rectus abdominus muscles and the perfusing artery and draining vein (donor-site). This free TRAM flap could be transplanted in the recipient-site after re-joining (re-anastomosing) the artery and vein using microsurgery. Aided by better anatomical knowledge, surgeons have been able to reduce the amount of rectus muscle sacrificed resulting in the muscle sparing-TRAM (MS-TRAM) and more latterly the deep inferior epigastric perforator (DIEP) flap which has no muscle included. The advantages of this muscle sparing approach are speedier recovery and reduced morbidity while maintaining operative cosmetic outcomes.

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