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

• Published in: Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2023-09, Vol.84, p.618-625
• Main Authors: Changchien, Chih-Hsuan, Fang, Chien-Liang, Hsu, Chin-Hao, Yang, Hsin-Yi, Lin, Yi-Ling
• Format: Article
• Language: English
• Subjects: Breast reconstruction; DIEP flap; Recipient vessels; Selection
• ISSN: 1748-6815; 1878-0539
• DOI: 10.1016/j.bjps.2023.06.049

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. 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). However, the anastomosis time was longer in IM and TA than in CS, TD, and LT (p  0.05). 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.