Transverse upper abdominal scars in DIEP flaps: pushing the limit of donor site abdominal skin perfusion

We present two immediate breast reconstruction cases utilising deep inferior epigastric perforator (DIEP) flaps in the presence of upper transverse abdominal scars and their outcomes. The available evidence in relation to its impact on abdominal skin perfusion and published clinical experience is reviewed.

Download Full-text

Breast Reconstruction After Resection of Bilateral Giant Phyllodes Tumors: Two Separate Deep Inferior Epigastric Perforator Flaps From One Donor Site

Clinical Breast Cancer ◽

10.1016/j.clbc.2019.11.007 ◽

2020 ◽

Vol 20 (2) ◽

pp. e188-e191

Author(s):

Chin-Wen Tu ◽

Chien-Liang Fang ◽

Chong-Bin Tsai ◽

Chin-Hao Hsu ◽

Chih-Hsuan Changchien ◽

...

Keyword(s):

Breast Reconstruction ◽

Donor Site ◽

Perforator Flaps ◽

Phyllodes Tumors ◽

Deep Inferior Epigastric Perforator

Download Full-text

Morphomic analysis aids pre-operative donor site risk assessment of breast cancer patients undergoing deep inferior epigastric perforator flap breast reconstruction

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2013.07.199 ◽

2013 ◽

Vol 217 (3) ◽

pp. S88-S89

Author(s):

Jacob Ronald Rinkinen ◽

Benjamin Levi ◽

Matthew Benedict ◽

David Hiltzik ◽

Isaac Stein ◽

...

Keyword(s):

Breast Cancer ◽

Risk Assessment ◽

Breast Reconstruction ◽

Cancer Patients ◽

Donor Site ◽

Perforator Flap ◽

Breast Cancer Patients ◽

Deep Inferior Epigastric Perforator

Download Full-text

The Influence of Closing the Abdominal Donor-Site Superficial Fascial System in Deep Inferior Epigastric Perforator Flap Breast Reconstruction

Plastic & Reconstructive Surgery ◽

10.1097/prs.0000000000008297 ◽

2021 ◽

Vol 148 (3) ◽

pp. 357e-364e

Author(s):

Ariel C. Johnson ◽

Becky B. T. King ◽

Salih Colakoglu ◽

Jerry H. Yang ◽

Tae W. Chong ◽

...

Keyword(s):

Breast Reconstruction ◽

Donor Site ◽

Perforator Flap ◽

Deep Inferior Epigastric Perforator ◽

Superficial Fascial System

Download Full-text

DIEP and Muscle Sparing Breast Free Flap

Operative Plastic Surgery ◽

10.1093/med/9780190499075.003.0075 ◽

2019 ◽

pp. 781-794

Author(s):

Maurice Y. Nahabedian

Keyword(s):

Breast Reconstruction ◽

Free Flap ◽

Donor Site ◽

The Other ◽

No Donor ◽

Technical Aspects ◽

Body Habitus ◽

Deep Inferior Epigastric Perforator ◽

Muscle Sparing

The deep inferior epigastric perforator (DIEP) and muscle-sparing (MS) free transverse rectus abdominis musculocutaneous (TRAM) flaps are arguably the most common flaps used for autologous breast reconstruction. The benefit of these flaps is that very little to no donor site muscle is harvested. The decision to use one or the other is occasionally made preoperatively based on body habitus but often intraoperatively based on the quality of the perforating vessels. The technical aspects of the operation are similar except for the actual dissection around the perforating vessels. Studies have demonstrated no significant differences in outcome when comparing the DIEP and MS free TRAM flaps.

Download Full-text

Reinforcement of peritoneal repair in donor site post-concurrent laparotomy and rectus abdominis myocutaneous flap breast reconstruction using autologous dermal graft repair from zone 4 of deep inferior epigastric perforator flap: A case series in Asian patients

Indian Journal of Plastic Surgery ◽

10.4103/0970-0358.182237 ◽

2016 ◽

Vol 49 (01) ◽

pp. 119-121

Author(s):

Priya Tiwari ◽

Bien Keem Tan

Keyword(s):

Breast Reconstruction ◽

Myocutaneous Flap ◽

Donor Site ◽

Case Series ◽

Perforator Flap ◽

Rectus Abdominis ◽

Dermal Graft ◽

Asian Patients ◽

Rectus Abdominis Myocutaneous Flap ◽

Deep Inferior Epigastric Perforator

Download Full-text

Refractory Donor-Site Seroma Following DIEP Breast Reconstruction

Plastic Surgery Case Studies ◽

10.1177/2513826x19898831 ◽

2020 ◽

Vol 6 ◽

pp. 2513826X1989883

Author(s):

Trina V. Stephens ◽

Nancy Van Laeken ◽

Sheina A. Macadam

Keyword(s):

Literature Review ◽

Breast Reconstruction ◽

Donor Site ◽

Diep Flap ◽

First Line ◽

Percutaneous Aspiration ◽

Autologous Breast Reconstruction ◽

History Of ◽

Deep Inferior Epigastric Perforator ◽

Latissimus Dorsi Flaps

Donor-site seroma formation is a complication of autologous breast reconstruction reported most commonly with the use of latissimus dorsi flaps. First-line treatment is percutaneous aspiration which leads to resolution in the majority of cases. Those that persist may progress to a chronic, refractory seroma, which can prove challenging in terms of treatment. The aim of this article is to provide an updated literature review of interventions for chronic donor-site seroma and present the case of a 65-year-old female with a recalcitrant abdominal seroma following deep inferior epigastric perforator (DIEP) flap breast reconstruction. Literature review revealed a single article that reported 2 cases of persistent donor-site seroma after DIEP flap breast reconstruction. The patient presented here underwent repeat aspiration, drain placement, and multiple surgical procedures to achieve resolution. In total, the post-reconstruction seroma history of the patient extended over approximately 14 months. We conclude with evidence-based suggestions for chronic, donor-site seroma prevention and treatment.

Download Full-text

Perioperative nursing for immediate breast reconstruction with deep inferior epigastric perforator flap after breast cancer resection

Journal of Thoracic Disease ◽

10.21037/jtd.2018.07.58 ◽

2018 ◽

Vol 10 (7) ◽

pp. 4017-4022

Author(s):

Shufang Tan ◽

Lifen Pan ◽

Haixuan Zhao ◽

Jiemin Hu ◽

Huiyi Chen

Keyword(s):

Breast Cancer ◽

Breast Reconstruction ◽

Perforator Flap ◽

Immediate Breast Reconstruction ◽

Cancer Resection ◽

Perioperative Nursing ◽

Deep Inferior Epigastric Perforator

Download Full-text

Alternative flaps for microsurgical breast reconstruction

10.1093/med/9780199682874.003.0093 ◽

2021 ◽

pp. 1107-1114

Author(s):

Hinne A. Rakhorst

Keyword(s):

Breast Reconstruction ◽

Standard Care ◽

Donor Site ◽

Perforator Flap ◽

Donor Site Morbidity ◽

The Body ◽

Diep Flap ◽

Deep Inferior Epigastric Perforator ◽

Muscle Sparing ◽

Breast Reconstructive Surgery

Microsurgery in general has made dramatic improvements over the past decades. This applies to microsurgery in general and to breast reconstructive surgery especially. The demand for autologous breast reconstruction has risen. Since the introduction of the free transverse rectus abdominis myocutaneous (TRAM) flaps, through the muscle-sparing TRAM, flaps designs have evolved into the current gold standard, the deep inferior epigastric perforator (DIEP) flap. From experiences and increasing numbers of flap procedures performed by surgeons, techniques became more familiar and part of standard care. These factors gave rise to the development of a growing number of areas of the body where tissues of interest can be harvested using perforator flap-based techniques. This chapter discusses the most common as well as the ‘rising stars’ in terms of flaps to be used as alternative flaps to the DIEP flap for breast reconstruction. It discusses practical issues on dissection as well as donor site morbidity.

Download Full-text