title: [Clinical application of intensive CT in pedicled deep inferior epigastric perforator flap design].
abstract: OBJECTIVE
  To explore the effect of the intensive CT on the deep inferior epigastric perforator (DIEP) flap design strategy.
  
  
  METHODS
  From June 2007 to March 2008, 7 patients received reconstructive operation of the vertical DIEP flap, among whom there were 5 females with congenital absence of vagina and 2 males with peno-scrotal Paget's disease, aged 18-62 years old. Before the operation, the intensive CT scans were applied to all the patients in search for DIEP. The flaps were designed according to the radiological findings. The scrotum and penis defects were reconstructed in 2 cases and vaginal reconstruction was performed in 5 cases. The flap dimension ranged from 15 cm x 7 cm to 22 cm x 5 cm. The donor site was closed directly.
  
  
  RESULTS
  A total of 10 ideal perforating branches of all the 7 DIEP flaps were found before the operation, with the diameter of over 1.5 mm. Of the 7 flaps, 4 had 1 perforating branch and the other 3 had 2 perforating branches. All 7 flaps survived completely. The incisions of 6 patients obtained healing by first intention. Only 1 patient with Paget's disease had erosion at the scrotum incision and partial necrosis 7 days after the operation, and then healed after discontinuous dressing change. The incisions at the donor site obtained healing by first intension. Two patients complained about draw-off at the lower abdomen on the operated side, which was basically relieved at 7 days after the operation. All patients were followed up for 1 to 10 months (4.5 months on average). No operation-related complication was observed after operation. Six patients were satisfied with the reconstructive results. Only 1 patient was dissatisfied with the buried pennies and requested a revision.
  
  
  CONCLUSIONS
  The intensive CT scans play an important role in the DIEP flap design. It can not only make the flap safer, but also decrease operation time and improve efficiency.
authors.affiliation: Department of Plastic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100032, PR China.
authors.forename: Ang
authors.initials: A
authors.lastname: Zeng
authors.forename: Qun
authors.initials: Q
authors.lastname: Qiao
authors.forename: Borong
authors.initials: B
authors.lastname: Fang
authors.forename: Yi
authors.initials: Y
authors.lastname: Jia
authors.forename: Hailin
authors.initials: H
authors.lastname: Zhang
authors.forename: Lin
authors.initials: L
authors.lastname: Zhu
authors.forename: Bo
authors.initials: B
authors.lastname: Pan
mesh_terms: D000293:Adolescent; D000328:Adult; D017076:Computer-Aided Design; D019074:Epigastric Arteries / Q000000981:diagnostic imaging* / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement; D013524:Surgical Flaps; D036542:Tomography, Spiral Computed