Evaluation of Multiple Perforators Deep Inferior Epigastric Artery Perforator (DIEAP) Flap Outcome in Breast Reconstruction

Breast reconstruction is now considered an elemental part of breast cancer management protocols. Public awareness of breast reconstruction has improved but it needs more systematized effort especially in underserved populations with relatively low socioeconomic standards. The aim of the present study was to clinically evaluate multiple deep inferior Epigastric perforator (DIEP) flap outcome in patients undergoing breast reconstruction. This study included 20 female patients who had either unilateral or bilateral mastectomy, and underwent breast reconstruction using multiple perforators DIEP flap at Plastic and Reconstructive Surgery Department, Zagazig University Hospitals. A total of 21 flaps were performed over the 3-year period. Patient selection and preparation according to ERAS protocols were done. Inclusion of more than one perforator was tried in all patients and achieved in 82% of flaps. Flap survival was considered the primary outcome. Follow up was done for 6 months postoperatively. Fat necrosis and patient reported outcome was considered as the secondary outcomes. Statistical analysis described factors that can influence results with emphasis on the effect of multiple perforators on different measures of outcome. Major complications incidence was 23 % in the form of total flap loss (14.3%) and partial flap loss (9.5 %). The outcomes of multiple perforators DIEP demonstrates encouraging outcomes by achieving enhanced flap perfusion by decreasing the flow resistance, less degree of fat necrosis and good patient satisfaction.