A Combined Anatomical and Clinical Study for Quantitative Analysis of the Microcirculation in the Classic Perfusion Zones of the Deep Inferior Epigastric Artery Perforator Flap

Rahmanian-Schwarz, Afshin; Rothenberger, Jens; Hirt, Bernhard; Luz, Oliver; Schaller, Hans-Eberhard

doi:10.1097/prs.0b013e3181fed543

Cited by 32 publications

(47 citation statements)

References 20 publications

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“…The medial row perforators routinely cross the midline to perfuse the medial parts of the contralateral hemiabdominal wall and have more extensive branching and larger caliber vessels than lateral row perforators. [17][18][19][20][21] Analyzing the vascularization of the horizontal parts in zone I, we found the best vascularization in the middle 1/3 part. Also, we found the perforators with the largest diameter in this part (region 5).…”

Section: Discussionmentioning

confidence: 96%

“…15,16 Until recently, the Hartrampf perfusion zones were standard for selection of the DIEP flap tissue, but more recent studies show that the establishment of zoning is somewhat complex and contradictory. [17][18][19][20][21] We used the gelatin injection technique to define the vascular anatomy of the lower abdominal wall parts. Limitation of these cadaveric studies is inability to mimic physiological conditions, vasoconstriction and physiological shunting.…”

Section: Discussionmentioning

confidence: 99%

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Deep inferior epigastric perforator flap: An anatomical study of the perforators and local vascular differences

et al. 2011

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The objective of this study was to determine precise localization and external diameter of the lower abdominal wall perforators as well as to investigate some vascularity differences between the same parts of perfusion zones II and III according to Hartrampf perfusion zones. The study was performed on 10 fresh cadavers (20 hemiabdomens) using the gelatin injection technique. All perforators were identified, and their localization and diameter were noted. Measurements were made at the level of the fascia. We noted localization and diameter of arteries on cross-sectional planes of either part of the flap. The median sum of the external diameter of all arteries in zone I was 17.01 mm. The median sum of the external diameter of all arteries in the medial 1/3 part of zone III was 4.17 mm, and in the medial 1/3 part of zone II, it was 0.96 mm. The median sum of the external diameter of all arteries in the intermediary 1/3 part of zone III was 2.16 mm, whereas in the intermediary 1/3 part of zone II, it was 0.81 mm. Significant differences were recorded between proximal and middle horizontal regions of zones II and III and between medial vertical part of zone III and medial vertical part of zone II. Anastomoses between zones I and II are considerably smaller compared with anastomoses between zones I and III. The best vascularized parts of the lower abdominal wall were perfusion zone I, then the inner 2/3 of zone III and medial 1/3 of zone II.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Deep inferior epigastric perforator flap: An anatomical study of the perforators and local vascular differences

et al. 2011

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“…However, perforators that arise on a more lateral aspect of the abdomen will have different perforasomes than those arising on the medial aspect. 25 We found this to be the case in 42% of our patients. In this subset of patients, the flap design may be altered to accommodate a lateral row dominant perforator (from 3.5 to 8 cm lateral to the umbilicus) that will have different perfusion zones.…”

Section: Discussionmentioning

confidence: 79%

Localization of the Dominant Deep Inferior Epigastric Artery Perforator by Computed Tomography Angiogram

Saad

Rebowe

Hogan

et al. 2014

Annals of Plastic Surgery

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The standard DIEP flap design incorporates most of the dominant perforating vessels. However, a significant number of perforators arise at or above the umbilicus, which would be near the edge or out of the standard design of the DIEP. Our findings support the use of preoperative CTA in the evaluation of patients undergoing DIEP free flap reconstruction. Modification of flap design to include the dominant perforating vessels should be considered when the dominant vessel is outside the standard design of the DIEP.

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“…The anatomical context of these techniques was described by Taylor [12]. Schlussendlich wird die Durchblutung des Unterbauchlappens sowohl ipsi-als auch kontralateral durch eine Vielzahl von Faktoren beeinflusst; deshalb erscheint eine verlässliche, individuelle Beurteilung der Perfusion so wichtig und wertvoll [13].…”

Section: Mammaplastik · Chirurgische Lappen · Perfusionszonen · Indozunclassified

Anatomische Variabilität der Durchblutung am Unterbauch

Ninković

Broer

2015

J Ästhet Chir

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A Combined Anatomical and Clinical Study for Quantitative Analysis of the Microcirculation in the Classic Perfusion Zones of the Deep Inferior Epigastric Artery Perforator Flap

Cited by 32 publications

References 20 publications

Deep inferior epigastric perforator flap: An anatomical study of the perforators and local vascular differences

Deep inferior epigastric perforator flap: An anatomical study of the perforators and local vascular differences

Localization of the Dominant Deep Inferior Epigastric Artery Perforator by Computed Tomography Angiogram

Anatomische Variabilität der Durchblutung am Unterbauch

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