title: Superior epigastric artery perforator (SEAP) flap: a novel approach to autologous breast reconstruction.
abstract: BACKGROUND
  Although free tissue breast reconstruction has been increasingly used, it remains challenging to perform outside of specialized centers due to facility and personnel limitations. We describe a preclinical study highlighting the feasibility of a pedicled, superior epigastric artery perforator (SEAP) flap utilizing lower abdominal tissues similar to a transverse rectus abdominus myocutaneous (TRAM) reconstruction, but with decreased donor-site morbidity.
  
  
  METHODS
  Fresh cadavers were dissected generating a total of 32 SEAP flaps. These flaps were subsequently studied for transposition potential and vascularity utilizing computed tomographic (CT) imaging.
  
  
  RESULTS
  An obvious, single, dominant SEAP was appreciated, and a developed flap was routinely capable of reaching either nipple-areola complex with simple interposition. Cadaveric CT imaging revealed global contrast filling in each dissected hemi-abdomen tested.
  
  
  CONCLUSIONS
  We describe a preclinical study utilizing a novel pedicled, SEAP flap for aesthetic breast reconstruction. While this will not obviate the use of free tissue transfer, it may add to the surgical armamentarium for aesthetic restoration in the breast cancer patient.
authors.affiliation: Department of Plastic Surgery, Institute of Dermatology and Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Neilendu
authors.initials: N
authors.lastname: Kundu
authors.affiliation: Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Karan
authors.initials: K
authors.lastname: Chopra
authors.affiliation: Department of Diagnostic Radiology & Nuclear Medicine: Neuroradiology, University of Maryland Medical Center, Baltimore, MD, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Morales
authors.affiliation: Department of Plastic Surgery, Institute of Dermatology and Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Risal
authors.initials: R
authors.lastname: Djohan
authors.affiliation: Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Chung
authors.affiliation: Department of Plastic Surgery, Institute of Dermatology and Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA. Electronic address: gastmab@ccf.org.
authors.forename: Brian R
authors.initials: BR
authors.lastname: Gastman
mesh_terms: D034861:Abdominal Wall; D002102:Cadaver; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008866:Microsurgery; D061525:Perforator Flap / Q000637:transplantation*; D014057:Tomography, X-Ray Computed
keywords: Abdominal wall; Breast reconstruction; Microsurgery; Superior epigastric artery perforator flap