[Clinical experiences of breast reconstruction using deep inferior epigastric perforator flaps].
OBJECTIVE
To summarize the experiences of the breast reconstruction using the deep inferior epigastric perforator (DIEP) flaps.


METHODS
From March 2000 to March 2005, 18 cases of breast defects were treated. Defect was caused by mammary cancer in 17 cases and by Poland's syndrome in 1 case. Preoperative radiotherapy was given in 7 patients. The size of the chest wall defects ranged from 25 cm X 20 cm to 12 cm X 8 cm. All the breasts were reconstructed with the DIEP flaps. The flap size ranged from 35 cm X 22 cm to 12 cm X 8 cm (mean 9.58 cm X 26.85 cm). The internal mammary vessels were used as the recipient vessels in 15 patients who underwent delayed breast reconstruction. Among these cases, the bilateral deep inferior epigastric vessels were anastomosed with the proximal and distal ends of the internal mammary vessels separately in 13 cases and only unilateral deep inferior epigastric vessels were harvested and anastomosed to the proximal ends of the internal mammary vessels in 2 cases. The recipient vessels were the thoracodorsal vessels and thoracodorsal vessels plus the circumflex scapular vessels in the patients who underwent immediate breast reconstruction.


RESULTS
Sixteen flaps survived completely postoperatively and the survival rate was 89%. Flap necrosis occurred in 2 patients; one underwent radiotherapy preoperatively while the other did not. The distal 1/3 portion of the flap necrosed in the patient with Poland's syndrome. Nipple reconstruction and breast remolding were performed in 2 patients. Partial dehiscence of the median abdominal incision occurred in 2 patients at 2 weeks postoperatively and were repaired with resuturing and split-thickness skin grafting separately.


CONCLUSIONS
Breast reconstruction using the DIEP flaps not only can preserve the advantages of the traditional method using the transverse rectus abdominis myocutaneous flaps, but also can retain the maximal function of the rectus abdominal muscle and prevent the occurrence of abdominal weakness and hernia. It is an ideal method of the breast reconstruction.
Liu
Yuanbo
Y
Plastic Surgery Hospital of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100041, P.R. China. yuanbobj@public3.bta.net.cn
Xu
Jun
J
Wang
Jing
J
D000328:Adult; D001943:Breast Neoplasms / Q000601:surgery; D019074:Epigastric Arteries; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D016038:Skin Transplantation; D013524:Surgical Flaps / Q000098:blood supply*