Creating a context for recipient vessel selection in deep inferior epigastric perforator flap breast reconstruction

被引:3
作者
Changchien, Chih-Hsuan [1 ,2 ,5 ]
Fang, Chien-Liang [1 ,3 ,5 ]
Hsu, Chin-Hao [1 ,5 ]
Yang, Hsin-Yi [4 ,5 ]
Lin, Yi-Ling [1 ,5 ]
机构
[1] Chia Yi Christian Hosp, Ditmanson Med Fdn, Dept Surg, Div Plast & Reconstruct Surg, Chia Yi City, Taiwan
[2] Asia Univ, Coll Med & Hlth Sci, Dept Med Lab Sci & Biotechnol, Taichung, Taiwan
[3] Asia Univ, Coll Med & Hlth Sci, Dept Food Nutr & Hlth Biotechnol, Taichung, Taiwan
[4] Chia Yi Christian Hosp, Ditmanson Med Fdn, Clin Med Res Ctr, Chia Yi City, Taiwan
[5] 539 Jhongsiao Rd, Chia Yi City 60002, Taiwan
关键词
Recipient vessels; Selection; DIEP flap; Breast reconstruction; INTERNAL MAMMARY VESSELS; ABDOMINAL FREE FLAPS; DIEP FLAPS; THORACOACROMIAL VESSELS; VENOUS CONGESTION; FREE TRAM; VEIN; COMPLICATIONS; AXILLARY; ANATOMY;
D O I
10.1016/j.bjps.2023.06.049
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: In autologous tissue breast reconstruction, recipient vessels are important for artery perfusion and venous drainage to ensure free flap survival. There are insufficient clinical outcomes to select efficient recipient vessels in bi-pedicled deep inferior epigastric perforator (DIEP) flap reconstruction. Methods: We presented a retrospective observational series of 108 patients regarding the diameter, anastomosis time, and re-anastomosis rate in internal mammary (IM), circumflex scapular (CS), thoracodorsal (TD), thoracoacromial (TA), lateral thoracic (LT), and internal mammary perforator (IMP) vessels of bi-pedicled DIEP flaps for breast reconstruction after mastectomy. The outcomes were the vessel re-anastomosis rate, flap failure rate, vessel anastomosis time, and complications. Data were gleaned from the chi-square test, Fisher's test, and analysis of variance using Scheffe's test as a post hoc analysis. The level of significance was p < 0.05. Results: There were no significant differences in the diameters of the artery, first vein, and second vein across the recipient vessels (p > 0.05). However, the anastomosis time was longer in IM and TA than in CS, TD, and LT (p < 0.001). Also, there were no significant differences for re-anastomosis, flap necrosis, and fat necrosis among different recipient vessels (p > 0.05). Conclusions: Because of the altered mastectomy incisions, this study provides complete anatomical vascular properties and suggests that altering recipient vessel selection for bi-pedicled DIEP flaps can shorten anastomosis time and better conceal scars. (c) 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd.
引用
收藏
页码:618 / 625
页数:8
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