title: A decision-making algorithm for recipient vein selection in bipedicle deep inferior epigastric artery perforator flap autologous breast reconstruction.
abstract: The bipedicle deep inferior epigastric artery perforator (DIEP) flap allows reliable transfer of the entire lower abdominal flap in patients who have a small pannus or require a large volume breast reconstruction. Selection of recipient vessels for the second pedicle can however, be challenging. We describe our experience with a consecutive series of twenty three bipedicle DIEP flaps with particular focus on selection of the recipient veins. We demonstrate that with judicious selection the internal mammary system can be reliably used as recipients for both pedicles with low complication rates.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery and Surgical Oncology, University Health Network, University of Toronto, Toronto, Canada. Electronic address: Anne.O'Neill@uhn.ca.
authors.forename: Anne C
authors.initials: AC
authors.lastname: O'Neill
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery and Surgical Oncology, University Health Network, University of Toronto, Toronto, Canada.
authors.forename: Natalie C
authors.initials: NC
authors.lastname: Ngan
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery and Surgical Oncology, University Health Network, University of Toronto, Toronto, Canada.
authors.forename: Jennica
authors.initials: J
authors.lastname: Platt
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery and Surgical Oncology, University Health Network, University of Toronto, Toronto, Canada.
authors.forename: Anisah
authors.initials: A
authors.lastname: Mahomed
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery and Surgical Oncology, University Health Network, University of Toronto, Toronto, Canada.
authors.forename: Toni
authors.initials: T
authors.lastname: Zhong
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery and Surgical Oncology, University Health Network, University of Toronto, Toronto, Canada.
authors.forename: Stefan O P
authors.initials: SO
authors.lastname: Hofer
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D000714:Anastomosis, Surgical; D003657:Decision Making; D019074:Epigastric Arteries / Q000637:transplantation*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D016462:Mammaplasty; D008323:Mammary Arteries / Q000601:surgery; D008875:Middle Aged; D061525:Perforator Flap / Q000098:blood supply*; D011183:Postoperative Complications; D017568:Rectus Abdominis / Q000637:transplantation; D012189:Retrospective Studies; D014680:Veins / Q000601:surgery*
keywords: Autologous breast reconstruction; Bipedicle DIEP flap; Internal mammary vessels; Recipient vessels