Modifying techniques in deep inferior epigastric artery perforator flap harvest with the use of preoperative imaging.
Abstract New techniques in the harvest of deep inferior epigastric artery perforator (DIEP) flaps have become introduced as a result of modern imaging technologies that can allow virtual surgery to be achieved preoperatively. With computed tomographic angiography, individual anatomy can be appreciated in detail to a level not previously appreciated. These imaging techniques can be successfully used to guide DIEP flap surgery. 'Optimal' perforators can be selected based on size, location, intramuscular and subcutaneous course, and their association with motor nerves. Flap design can be safely achieved based on the cutaneous distribution of perforators. Abdominal wall closure can be improved based on the abdominal contour seen with imaging. Preoperative planning can aid patient selection, plan all aspects of the operative technique, reduce operating time and improve operative outcomes.
Rozen
Warren M
WM
Jack Brockhoff Reconstructive Plastic Surgery Research Unit, Room E533, Department of Anatomy and Cell Biology, The University of Melbourne, Grattan St., Parkville, Victoria 3050, Australia. warrenrozen@hotmail.com
Ashton
Mark W
MW
D034861:Abdominal Wall / Q000601:surgery; D001943:Breast Neoplasms / Q000601:surgery*; D019074:Epigastric Arteries / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy; D011300:Preoperative Care; D011859:Radiography; D013524:Surgical Flaps / Q000098:blood supply*; D020858:Tissue and Organ Harvesting / Q000379:methods*