title: Banking a hemi-abdominal DIEP flap: a pilot report of indications, technique, and utility.
abstract: We present a pilot report of "banking" the contralateral hemi-abdominal deep inferior epigastric perforator (DIEP) flap under the abdominal closure in patients undergoing unilateral autologous breast reconstruction when a hemi-abdominal flap suffices. Four patients undergoing unilateral autologous breast reconstruction with a hemi-abdominal DIEP or superficial inferior epigastric artery flap had their contralateral hemi-abdominal flap left in position, or "banked," under their abdominal closure to be used in case of failure. This novel method may be of assistance when a free microvascular hemi-abdominal flap is felt to be threatened or suspect. It provides a life-boat for the younger and experienced surgeon alike, and most importantly, for the breast cancer survivor. Economic analysis of the technique reveals that the contralateral hemi-abdominal flap should be banked more often than intuition alone would suggest.
authors.affiliation: Division of Plastic, Reconstructive and Maxillofacial Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
authors.forename: Sachin M
authors.initials: SM
authors.lastname: Shridharani
authors.forename: Navin K
authors.initials: NK
authors.lastname: Singh
authors.forename: Jesse A
authors.initials: JA
authors.lastname: Taylor
authors.forename: Gedge D
authors.initials: GD
authors.lastname: Rosson
mesh_terms: D034861:Abdominal Wall / Q000098:blood supply / Q000601:surgery; D000368:Aged; D003362:Cost-Benefit Analysis; D062109:Dermatologic Surgical Procedures; D019074:Epigastric Arteries / Q000601:surgery; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000191:economics / Q000379:methods*; D008866:Microsurgery / Q000191:economics / Q000379:methods*; D008875:Middle Aged; D010865:Pilot Projects; D012189:Retrospective Studies; D012867:Skin / Q000098:blood supply; D016038:Skin Transplantation / Q000191:economics / Q000379:methods; D050507:Subcutaneous Fat, Abdominal / Q000098:blood supply / Q000637:transplantation; D013524:Surgical Flaps / Q000098:blood supply* / Q000191:economics; D016896:Treatment Outcome