Feasibility and Safety of Using Perforators Through Tendinous Intersections of the Rectus Abdominis for DIEP Flap Breast Reconstruction: A Retrospective Study.
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引用次数: 0
Abstract
Background: The deep inferior epigastric perforator (DIEP) flap technique has gained popularity due to its muscle-sparing properties, significantly reducing morbidity and enhancing aesthetic outcomes in breast reconstruction. In a considerable number of patients, dominant perforators traverse tendinous intersections (TI) of the rectus abdominis muscle, referred to as intra-TI perforators (ITIP). Our study pursued two principal objectives: to determine the accuracy of preoperative computed tomography angiography (CTA) in identifying ITIP and to evaluate whether utilizing ITIP in DIEP flap harvest impacts flap perfusion or elevates the incidence of donor-site complications.
Methods: We conducted a retrospective analysis of 81 DIEP flaps from 54 female patients between 2022 and 2024. Patients were categorized into ITIP and NTIP groups based on the anatomical location of the dominant perforator. Preoperative CTA was used to identify perforator course. Intraoperatively, dissection time was recorded. Flap perfusion was quantitatively assessed using fluorescence imaging, and postoperative complications were monitored for 6 months.
Results: In this retrospective study, we found that although ITIP required longer dissection time, they provided reliable perfusion without increasing complication rates. Maximum correlation analysis found that the y-axis distance of ITIP had the strongest correlation with the dissection time.
Conclusion: ITIP flaps appreciate sufficient blood perfusion compared with NTIP flaps, and the incidence of complications is not increased, making it a feasible candidate for DIEP breast reconstruction.
Level of evidence iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors.
期刊介绍：
Aesthetic Plastic Surgery is a publication of the International Society of Aesthetic Plastic Surgery and the official journal of the European Association of Societies of Aesthetic Plastic Surgery (EASAPS), Società Italiana di Chirurgia Plastica Ricostruttiva ed Estetica (SICPRE), Vereinigung der Deutschen Aesthetisch Plastischen Chirurgen (VDAPC), the Romanian Aesthetic Surgery Society (RASS), Asociación Española de Cirugía Estética Plástica (AECEP), La Sociedad Argentina de Cirugía Plástica, Estética y Reparadora (SACPER), the Rhinoplasty Society of Europe (RSE), the Iranian Society of Plastic and Aesthetic Surgeons (ISPAS), the Singapore Association of Plastic Surgeons (SAPS), the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), the Egyptian Society of Plastic and Reconstructive Surgeons (ESPRS), and the Sociedad Chilena de Cirugía Plástica, Reconstructiva y Estética (SCCP).
Aesthetic Plastic Surgery provides a forum for original articles advancing the art of aesthetic plastic surgery. Many describe surgical craftsmanship; others deal with complications in surgical procedures and methods by which to treat or avoid them. Coverage includes "second thoughts" on established techniques, which might be abandoned, modified, or improved. Also included are case histories; improvements in surgical instruments, pharmaceuticals, and operating room equipment; and discussions of problems such as the role of psychosocial factors in the doctor-patient and the patient-public interrelationships.
Aesthetic Plastic Surgery is covered in Current Contents/Clinical Medicine, SciSearch, Research Alert, Index Medicus-Medline, and Excerpta Medica/Embase.
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