Management of Facial Contour Deformities with Deepithelialized Lateral Intercostal Free Flap

Badran, Hassan A.; Youssef, Mohammed Khaled H.; Shaker, Ayman

doi:10.1097/00000637-199607000-00015

Cited by 11 publications

(12 citation statements)

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“…The extensive anatomical studies of Kerrigan and Daniel 5 resulted in a better understanding of the clinical indications and surgical technique. Badran 6,7 was the first to describe the lateral intercostal fasciocutaneous flap based on one neurovascular bundle, sparing the abdominal musculature. However, intercostal flaps have not been widely reported in the literature because dissection of the main pedicle is difficult with potential incidence of pneumothorax.…”

Section: Discussionmentioning

confidence: 99%

“…Intercostal artery perforator (ICAP) flaps have been limited to case report publications. [6][7][8]13 The intercostal vessels form an arcade, between the aorta and the internal mammary vessels, which gives numerous perforators. Every single perforator can be a blood supply to a skin flap.…”

Section: Discussionmentioning

confidence: 99%

“…All reported cases of intercostal flaps, either fasciocutaneous or musculocutaneous, were harvested from the lower trunk as pedicled flaps for lumbosacral defects or as free flaps for distant regions. [1][2][3][4][5][6][7][8] An overview of the history, anatomy, definition and surgical technique of the intercostal artery perforator flaps are presented. The versatile clinical use of the intercostal artery perforator flaps for defects over the high trunk is demonstrated.…”

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confidence: 99%

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The versatility of the inter-costal artery perforator (ICAP) flaps

Hamdi

Landuyt

Frene

et al. 2006

Journal of Plastic, Reconstructive & Aesthetic Surgery

223

174

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Summary Introduction: Anatomy and classification of intercostal perforator flaps in addition to our experience with will be demonstrated for different indications. Material and methods: The intercostal vessels form an arcade between the aorta and the internal mammary vessels. Different pedicled perforator flaps can be raised on this neurovascular bundle to cover defects on the trunk. They are classified as following: dorsal intercostal artery perforator flap (DICAP); lateral intercostal artery perforator (LICAP); and anterior intercostal artery perforator (AICAP) flap. Results: Between 2001 and 2004, 20 pedicled (ICAP) flaps were harvested in 16 patients. The indications were: immediate partial breast reconstruction in eight patients who had a quadrantectomy for breast cancer; midline back and sternal defects in three patients who had radical excisions for a dermatofibrosarcoma or malignant melanoma; and autologous breast augmentation (four bilateral and one unilateral flap) in five post-bariatric-surgery patients. The average flap dimension was 18!8 cm 2 (range 8!5-24!12 cm 2 ). There were two DICAP flaps, two (AICAP) flaps and 16 (LICAP) flaps. All but two flaps were based on one perforator. Mean harvesting time was 45 min for a single flap. Bilateral breast augmentation with LICAP flap necessitated longer operative time (range 2-3 h) depending whether it was combined or not with mastopoexy. Complete flaps survival was obtained. All donor sites were closed primarily. Conclusion: The (ICAP) flaps provide valuable options in breast surgery; and for challenging defects on the trunk without sacrifice of the underlying muscle.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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The versatility of the inter-costal artery perforator (ICAP) flaps

Hamdi

Landuyt

Frene

et al. 2006

Journal of Plastic, Reconstructive & Aesthetic Surgery

223

174

View full text Add to dashboard Cite

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“…For this reason, before the perforator era, the flaps were harvested as musculocutaneous flaps, with random extensions beyond the thoracic cage, which needed delay procedures (Daniel et al, ). Badran was the first to describe the lateral intercostal fasciocutaneous flap base with the neurovascular bundle, sparing the abdominal musculature (Badran, Youssef, & Shaker, ).…”

Section: Discussionmentioning

confidence: 99%

Anterior intercostal artery perforator flap in immediate breast reconstruction: Anatomical study and clinical application

et al. 2017

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“…If the vertical length of these flaps is greater than this value, the circulation of the skin flap at the donor site may be affected. Although we experienced partial failure with a 15 cm×7 cm flap, the donor site healed without problems such as seroma or hematoma [16]. To avoid donor site morbidities, we elevated the adipofascial flap below Scarpa's fascia.…”

Section: Discussionmentioning

confidence: 99%

Face Reconstruction Using Lateral Intercostal Artery Perforator-Based Adipofascial Free Flap

et al. 2014

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BackgroundThe aim of this study was to determine the efficacy of lateral intercostal artery perforator-based adipofascial free flaps for facial reconstruction in patients with facial soft tissue deficiency.MethodsWe conducted a retrospective study of five consecutive patients diagnosed with facial soft tissue deficiency who underwent operations between July 2006 and November 2011. Flap design included the area containing the perforators. A linear incision was made along the rib, which had the main intercostal pedicle. First, we dissected below Scarpa's fascia as the dorsal limit of the flap. Then, the adipofascial flap was elevated from the medial to the lateral side, including the perforator that pierces the serratus anterior muscle after emerging from the lateral intercostal artery. After confirming the location of the perforator, pedicle dissection was performed dorsally.ResultsDominant perforators were located on the sixth to eighth intercostal space, and more than four perforators were found in fresh-cadaver angiography. In the clinical case series, the seventh or eighth intercostal artery perforators were used for the free flaps. The mean diameter of the pedicle artery was 1.36 mm, and the mean pedicle length was 61.4 mm. There was one case of partial fat necrosis. No severe complications occurred.ConclusionsThis is the first study of facial contour reconstruction using lateral intercostal artery perforator-based adipofascial free flaps. The use of this type of flap was effective and can be considered a good alternative for restoring facial symmetry in patients with severe facial soft tissue deficiency.

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Management of Facial Contour Deformities with Deepithelialized Lateral Intercostal Free Flap

Cited by 11 publications

References 0 publications

The versatility of the inter-costal artery perforator (ICAP) flaps

The versatility of the inter-costal artery perforator (ICAP) flaps

Anterior intercostal artery perforator flap in immediate breast reconstruction: Anatomical study and clinical application

Face Reconstruction Using Lateral Intercostal Artery Perforator-Based Adipofascial Free Flap

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