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Deep inferior epigastric

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https://www.readbyqxmd.com/read/28434811/predicting-and-planning-for-siea-flap-utilisation-in-breast-reconstruction-an-algorithm-combining-pre-operative-computed-tomography-analysis-and-intra-operative-angiosome-assessment
#1
Francis P Henry, Daniel P Butler, Simon H Wood, Navid Jallali
BACKGROUND: Low flap complication rates and excellent aesthetic outcomes are now commonplace in breast reconstruction. As a result, attention is now being focussed on minimising donor site morbidity. Despite its potential donor site advantages, the superficial inferior epigastric artery (SIEA) flap is often discounted, given concerns about the high flap failure rates. In this study, we present our experience of using the SIEA flap in breast reconstruction and provide an algorithm based on pre-operative computed tomography angiography (CTA) to aid pre-operative planning...
April 8, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28422830/management-of-the-extensive-thoracic-defects-after-deep-sternal-wound-infection-with-the-rectus-abdominis-myocutaneous-flap-a-retrospective-case-series
#2
Yue-Hua Li, Zhao Zheng, Jiaomei Yang, Lin-Lin Su, Yang Liu, Fu Han, Jia-Qi Liu, Da-Hai Hu
Deep sternal wound infection is a severe complication after open heart surgery. According to the different severity and dimensions of the deep sternal wound infection, the treatment method is different. In this study, we aimed to describe our experience with the rectus abdominis myocutaneous flap for large sternal wound management, especially when 1 or 2 internal mammary arteries were absent.Between October 2010 and January 2016, a retrospective review of 9 patients who suffered from the extensive thoracic defects after deep sternal wound infection was conducted...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28352599/assessment-of-tissue-perfusion-following-conventional-liposuction-of-perforator-based-abdominal-flaps
#3
Zeynep Deniz Akdeniz Doğan, Bülent Saçak, Doğuş Yalçın, Özgür Pilancı, Fatma Betül Tuncer, Özhan Çelebiler
BACKGROUND: The effect of liposuction on the perforators of the lower abdominal wall has been investigated in several studies. There are controversial results in the literature that have primarily demonstrated the number and patency of the perforators. The aim of this study was to determine the effect of liposuction on the perfusion of perforator-based abdominal flaps using a combined laser-Doppler spectrophotometer (O2C, Oxygen to See, LEA Medizintechnik). METHODS: Nine female patients undergoing classical abdominoplasty were included in the study...
March 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28340668/anastomosis-of-the-superficial-inferior-epigastric-vein-to-the-internal-mammary-vein-to-augment-deep-inferior-artery-perforator-flaps
#4
REVIEW
Aparna Vijayasekaran, Anita T Mohan, Lin Zhu, Basel Sharaf, Michel Saint-Cyr
Use of the retrograde limb of the internal mammary vein has been described previously as a lifeboat for venous congestion but not prophylactically. Maximizing the length of the deep inferior artery perforator (DIEP) flap pedicle, identifying and dissecting the superficial inferior epigastric vein proximally in every patient, and taking advantage of the retrograde internal mammary vein are all technical details that facilitate the additional venous anastomosis and flap inset. Performing a second venous anastomosis routinely using the superficial inferior epigastric vein to the retrograde internal mammary vein helps with flap inset...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340667/microsurgical-tissue-transfer-in-breast-reconstruction
#5
REVIEW
Nakul Gamanlal Patel, Venkat Ramakrishnan
Autologous breast reconstructions have grown in popularity because of their durability, aesthetic outcomes, symmetry, increase in external beam radiotherapy use, and potential aesthetic enhancement at the donor site. Increasing patient expectations for predictable high aesthetic outcomes with minimal complications or need for further procedures has been met by refinement in the use of flaps. The authors' microsurgical breast reconstruction center aims to provide this while delivering efficient service. The deep inferior epigastric flaps form 85% and transverse upper gracilis and profunda artery perforator flaps account for 10%; lumbar artery perforator flaps are a new addition to the authors' armamentarium...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28338587/medial-row-perforators-are-associated-with-higher-rates-of-fat-necrosis-in-bilateral-diep-flap-breast-reconstruction
#6
Parisa Kamali, Michelle Lee, Babette E Becherer, Winona Wu, Daniel Curiel, Bao Ngoc N Tran, Adam M Tobias, Samuel J Lin, Bernard T Lee
BACKGROUND: The purpose of this study is to evaluate perfusion related complications in bilateral deep inferior epigastric perforator (DIEP) flap breast reconstruction based on perforator selection. METHODS: A retrospective review of a prospectively maintained database was performed on all patients undergoing bilateral DIEP flap reconstruction at a single institution between 2004-2014. The hemiflaps were separated into three cohorts based on perforator location: lateral row only, medial row only, and medial plus lateral row...
March 3, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28333309/positive-margin-re-excision-following-immediate-autologous-breast-reconstruction-morbidity-cosmetic-outcome-and-oncologic-significance
#7
Oscar Ochoa, Constantine Theoharis, Steven Pisano, Minas Chrysopoulo, Peter Ledoux, Gary Arishita, Chet Nastala
Background: Acquisition of negative resection margins is paramount in the surgical management of operable breast cancer. Management of positive margins following mastectomy and immediate breast reconstruction is presently poorly defined. Objectives: The present study aims at defining morbidity and cosmetic sequela of re-excision procedures aimed at clearing involved mastectomy margins in the setting of immediate autologous breast reconstruction. Oncologic outcomes are recorded...
March 17, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28328628/unilateral-versus-bilateral-breast-reconstruction-is-less-really-more
#8
Lauren V Kuykendall, Bugra Tugertimur, Corin Agoris, Sara Bijan, Ambuj Kumar, Deniz Dayicioglu
OBJECTIVE: Over the recent years, there has been an increase in prophylactic mastectomies with an associated increase in bilateral breast reconstruction. We aimed to compare outcomes in terms of patient satisfaction with unilateral versus bilateral breast reconstruction after deep inferior epigastric perforator (DIEP) flap and implant-based reconstruction. METHODS: Patients who underwent breast reconstruction by a single surgeon between July 2011 and July 2015 were surveyed using the independently validated BREAST-Q questionnaire...
March 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28319327/bilateral-breast-reconstruction-with-deep-inferior-epigastric-perforator-flaps-in-slim-patients
#9
Maria Mani, Samer Saour, Kelvin Ramsey, Kieran Power, Paul Harris, Stuart James
BACKGROUND: Slim women are not always considered candidates for bilateral autologous breast reconstruction. The study aims to assess the volume considerations and complications of deep inferior epigastric perforator (DIEP) flap in bilateral breast reconstruction among slim patients. METHODS: All patients undergoing bilateral DIEP breast reconstruction at the Royal Marsden Hospital, London, September 2007-March 2015, were reviewed. Flap weight was compared to mastectomy weight (weight ratio) and complications were recorded...
March 20, 2017: Microsurgery
https://www.readbyqxmd.com/read/28302367/lateral-thigh-perforator-flap-for-breast-reconstruction-computed-tomographic-angiography-analysis-and-clinical-series
#10
Marco A Maricevich, Michael R Bykowski, M Asher Schusterman, Evan B Katzel, Michael L Gimbel
PURPOSE: Although abdominal-based flaps remain the first choice for autologous breast reconstruction, alternative donor sites are necessary when the abdomen is unavailable. Abdominal donor site suitability is determined, at times, according to deep inferior epigastric perforator (DIEP)-protocol computed tomographic angiography (CTA) results. CTA provides information about the pelvis/upper thigh that can be used to evaluate the suitability of other donor sites. This study aimed to examine the utility of DIEP-protocol CTA in the assessment of a lateral thigh perforator (LTP) flap...
May 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28293489/a-novel-strategy-to-supercharge-a-deep-inferior-epigastric-artery-perforator-flap-after-port-a-cath-removal
#11
Chad M Teven, Adrian S H Ooi, David W Chang, David H Song
Autologous breast reconstruction using the deep inferior epigastric artery perforator (DIEP) flap has become increasingly popular because of its unique advantages. However, compared with some other forms of abdominal-based autologous reconstruction, DIEP flaps are associated with an increased risk of venous congestion. Many techniques-or lifeboats-have been introduced to diagnose and treat this potentially devastating complication. In this case report, we describe a novel strategy to augment venous drainage when venous congestion is encountered...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28283212/-identification-of-perforating-vessels-by-augmented-reality-application-for-the-deep-inferior-epigastric-perforator-flap
#12
R Bosc, A Fitoussi, F Pigneur, V Tacher, B Hersant, J-P Meningaud
The augmented reality on smart glasses allows the surgeon to visualize three-dimensional virtual objects during surgery, superimposed in real time to the anatomy of the patient. This makes it possible to preserve the vision of the surgical field and to dispose of added computerized information without the need to use a physical surgical guide or a deported screen. TECHNIQUE: The three-dimensional objects that we used and visualized in augmented reality came from the reconstructions made from the CT-scans of the patients...
March 7, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/28259642/determining-the-best-recipient-vessel-site-for-autologous-microsurgical-breast-reconstruction-with-diep-flaps-an-anatomical-study
#13
Martin Lhuaire, Mikael Hivelin, Moustapha Dramé, Peter Abrahams, Reza Kianmanesh, Christian Fontaine, Laurent Lantieri
INTRODUCTION: The deep inferior epigastric perforator (DIEP) flap is a reliable and reproducible technique for autologous microsurgical breast reconstruction. Several recipient vessels sites for microvascular anastomosis have been described such as the internal thoracic vessels, the thoracodorsal vessels, and the circumflex scapular vessels. Nonetheless, the choice of the recipient site depends mainly on individual operator's experience and preferences, and currently the best recipient vessel site is under debate...
February 13, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28255154/immediate-simultaneous-bilateral-breast-reconstruction-with-deep-inferior-epigastric-diep-free-flap-and-transverse-rectus-abdominis-musculocutaneous-tram-pedicled-flap
#14
E J Roslan, E G Kelly, M A Zain, N H Basiron, F H Imran
Breast reconstructive surgery has evolved tremendously since its inception. Following tumour clearance surgery, physical restoration with breast reconstruction is an important aspect of physical and emotional rehabilitation. Various methods have been described to suit patients demand for the best aesthetic outcome. Surgeon's preference, experience and practicality of differing procedures must be considered. We describe a simultaneous bilateral breast reconstruction with free deep inferior epigastric (DIEP) flap and pedicled transverse rectus abdominis musculocutaneous (TRAM) flap immediately post mastectomies for bilateral breast cancers...
February 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28250439/a-retrospective-study-of-lymphatic-transverse-rectus-abdominis-myocutaneous-deep-inferior-epigastric-perforator-flaps-for-breast-cancer-treatment-induced-upper-limb-lymphoedema
#15
Zhuangqing Yang, Sheng Huang, Jiankui Wang, Yan Xi, Xiaojuan Yang, Qi Tang, Juan Du, Jianyun Nie, Tianning Zou, Shaoqing Zhou, Xueliang Tang, Dedian Chen
Breast cancer-related lymphoedema (BCRL) is a common and intractable complication. To evaluate the possible complications of using lymphatic transverse rectus abdominis myocutaneous/deep inferior epigastric perforator (TRAM/DIEP) flaps for breast reconstruction and BCRL treatment, 20 patients with moderate or severe BCRL were retrospectively enrolled between November 2012 and October 2014. 10 patients had undergone lymphatic TRAM/DIEP flap surgery were assigned to the surgery group. 10 patients unwilling to undergo reconstruction were assigned to the physiotherapy group treated with traditional physical therapy...
December 2017: Scientific Reports
https://www.readbyqxmd.com/read/28229288/complications-in-diep-flap-breast-reconstruction-after-mastectomy-for-breast-cancer-a-prospective-cohort-study-comparing-unilateral-versus-bilateral-reconstructions
#16
Ryckie G Wade, Sergio Razzano, Elaine M Sassoon, Richard M Haywood, Rozina S Ali, Andrea Figus
BACKGROUND: The demand for bilateral breast reconstructions is rising worldwide. In the UK, approximately 30% of breast cancer patients undergoing mastectomy choose autologous tissue breast reconstruction. Although the deep inferior epigastric perforator (DIEP) flap is gaining popularity, bilateral DIEP flap breast reconstruction remains a complex procedure and reliable outcome data are lacking. In the absence of clinical trials, evidence from cohort studies is needed to better inform clinicians and patients...
February 22, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28195672/predictors-of-satisfaction-and-quality-of-life-following-post-mastectomy-breast-reconstruction
#17
Hannah Matthews, Natalie Carroll, Derek Renshaw, Andrew Turner, Alan Park, Jo Skillman, Kate McCarthy, Elizabeth A Grunfeld
OBJECTIVE: Breast reconstruction is associated with multiple psychological benefits. However, few studies have identified clinical and psychological factors associated with improved satisfaction and quality of life. This study examined factors which predict satisfaction with breast appearance, outcome satisfaction and quality of life following post-mastectomy breast reconstruction. METHODS: Women who underwent post-mastectomy breast reconstruction between 2010 and 2016 received a postal questionnaire consisting of: The BREAST-Q Patient Reported Outcomes Instrument, The European Organisation for Research and Treatment of Cancer QLQ-30 Questionnaire, The Patient and Observer Scar Assessment Scale and a series of Visual-Analogue Scales...
February 13, 2017: Psycho-oncology
https://www.readbyqxmd.com/read/28187214/what-s-the-remedy-for-the-distal-necrosis-of-diep-flap-better-venous-drain-or-more-arterial-supply
#18
Yi Zhang, Tingliang Wang, Jiao Wei, Jinguang He, Tao Wang, Ying Liu, Hua Xu, Jiasheng Dong
BACKGROUND: We developed a novel pedicled DIEP flap model in rat to explore the possible remedy for the distal necrosis of the flap. METHODS: A deep inferior epigastric perforator (DIEP) flap, based on the second right cranial perforator (P2) as the main pedicle, was elevated in 48 Sprague-Dawley rats. The rats were randomized into 4 groups: group I, the left P2 remaining intact as supercharging; group II, the left P2 artery alone kept as supercharging; group III, the left P2 vein alone kept as supercharging; group IV, no supercharging...
2017: PloS One
https://www.readbyqxmd.com/read/28130560/the-reconstruction-choice-for-giant-phyllodes-tumor-of-breast-bi-pedicled-deep-inferior-epigastric-perforator-flap
#19
Chien-Liang Fang, Chin-Hao Hsu, Chin-Wen Tu
BACKGROUND: Phyllodes tumors of the breast are the rarest of all breast neoplasms. Giant phyllodes tumors (>10 cm) of the breast have been less discussed in the literature. Reconstruction of the large defect created after wide excision (safety margin >1 cm) is a challenge in these patients. We present one technique using a bi-pedicled deep inferior epigastric perforator flap for post-mastectomy breast reconstruction for giant phyllodes tumors. METHODS AND RESULTS: We treated three patients with giant phyllodes tumors between 2013 and 2016...
January 27, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28122466/blood-loss-and-duration-of-surgery-are-independent-risk-factors-for-complications-after-breast-reconstruction
#20
Andri Thorarinsson, Victoria Fröjd, Lars Kölby, Albert Modin, Richard Lewin, Anna Elander, Hans Mark
BACKGROUND: Complications after breast reconstructive surgery are common, and they can be caused by a wide range of factors. The aim of the present study was to identify independent perioperative risk factors for postoperative complications after breast reconstruction. METHODS: A retrospective study was performed of 623 consecutive breast cancer patients who had undergone deep inferior epigastric perforator (DIEP) flap, latissimus dorsi (LD) flap, lateral thoracodorsal flap (LTDF), or tissue expander with secondary implant (EXP)...
January 26, 2017: Journal of Plastic Surgery and Hand Surgery
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