Neurovascular anatomy of the deep inferior epigastric perforator flap for breast reconstruction.
OBJECTIVE
To find out the most suitable perforator and cutaneous nerve for strategic design of the deep inferior epigastric perforator (DIEP) flap.


METHODS
The characteristics of the pedicles, perforators, intercostal nerves and the relationship between nerves and vessels in DIEP flaps were studied in 31 formalin-preserved cadavers.


RESULTS
Four hundred and five perforator vessels were divided into three vertical rows. These perforators were mostly contained in the medial row (45.4%), the average size of the perforators in the lateral row was the largest (1.0+/- 0.3 mm). The largest perforators (1.4+/- 0.3 mm) were mostly located within 1 cm horizontally from the umbilicus. Lateral row perforators, usually rectilinear course (82.7%), traveled with nerves from the beginning. Whereas, the perforators in the medial row usually coursed obliquely (86.4%) and were not related to nerves initially, they joined before piercing the rectus sheath.


CONCLUSIONS
The present findings indicate that it would be more beneficial to use the lateral row perforators.
Tansatit
Tanvaa
T
Department of Anatomy, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok 10330, Thailand. tansatit@yahoo.com
Chokrungvaranont
Prayuth
P
Sanguansit
Pasinee
P
Wanidchaphloi
Samang
S
D002102:Cadaver; D005260:Female; D006801:Humans; D007367:Intercostal Nerves / Q000033:anatomy & histology*; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy; D013524:Surgical Flaps / Q000098:blood supply* / Q000294:innervation