How long are fasciocutaneous flaps dependant on their vascular pedicle: a unique case of SIEA flap survival.
BACKGROUND
While it has long been held that muscle flaps maintain their dependency on their vascular pedicle for the long term, fasciocutaneous flaps have been less well investigated. Recent studies of the deep inferior epigastric artery perforator (DIEP) flap have suggested that these flaps may maintain long term dependence on their vascular pedicles for survival. There is no literature concerning these effects in the superficial inferior epigastric artery (SIEA) flap.


METHODS
We describe a unique case in which the pedicle of a superficial inferior epigastric artery (SIEA) flap for breast reconstruction was avulsed 11 days postoperatively, with the flap surviving on its inferior wound edge alone.


CONCLUSIONS
Fasciocutaneous flaps may lose dependency on their vascular pedicles in the short term following transfer, developing alternative pathways for vascular supply and ultimately survival. A conservative approach early in the course of flap compromise due to perforator ligation or avulsion, in cases where immediate re-anastomosis may not be feasible, is thus supported.
Enajat
Morteza
M
Department of Plastic Surgery, Uppsala Clinic Hospital, Uppsala 75185, Sweden. m.enajat@live.nl
Rozen
Warren M
WM
Whitaker
Iain S
IS
Audolfsson
Thorir
T
Acosta
Rafael
R
D001943:Breast Neoplasms / Q000601:surgery; D019074:Epigastric Arteries; D005205:Fascia / Q000098:blood supply / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy; D008875:Middle Aged; D012867:Skin / Q000098:blood supply*; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply*; D014945:Wound Healing