Paraumbilical Perforator Flap without Deep Inferior Epigastric Vessels

Koshima, Isao; Inagawa, Kiichi; Urushibara, Katsuyuki; Moriguchi, Takahiko

doi:10.1097/00006534-199809020-00020

Cited by 97 publications

(48 citation statements)

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“…Defects of the dorsal surface of the hand or foot require thin tissue for reconstruction, and many suitable flaps have been reported in the literature, such as thin cutaneous flaps of the anterolateral thigh, 7,8 deep inferior epigastric perforator flap, 9,10 temporoparietal fascia flap, [11][12][13] and lateral upper arm fascia flap. 14 Some of these flaps require thinning procedures, which may limit their application because partial skin necrosis may develop, especially in patients who have scar in the flap.…”

Section: Discussionmentioning

confidence: 99%

The thoracodorsal vascular tree‐based combined fascial flaps

2008

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In this study, combined fascial flaps pedicled on the thoracodorsal artery and vein were raised and used for thin coverage of dorsal surfaces of the fingers and the dorsum of hand and foot with favorable results. The combined fascial flaps consist of the serratus anterior fascia and the axillary fascia at the entrance of the latissimus dorsi. These flaps were used for reconstruction of the hand, fingers, or foot in nine patients. Reconstruction was performed for burn or burn scar contracture, after resection of malignant tumors, posttraumatic skin defects, and chronic regional pain syndrome. The sites of reconstruction were dorsal surfaces of fingers, dorsum of hand, wrist and palm, forearm, lower leg, and foot. The flaps were used in various configurations including two independent fascial flaps, two-lobed fascial flap with separate feeding vessels, and composite fascial and thoracodorsal artery perforator flap. The fascial and skin flaps survived in all nine patients, with favorable results both functionally and esthetically. Good coverage of soft tissue defects and good recovery of range of motion in resurfaced joints were achieved. There were no complications. The scars at the sites of harvest were not noticeable. The advantage of this method is that not only a single flap but flaps of a variety of configurations can be harvested for different purposes. The thoracodorsal vascular tree-based combined fascial flaps are useful for the reconstruction of soft tissue defects in the extremities.

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Section: Discussionmentioning

confidence: 99%

The thoracodorsal vascular tree‐based combined fascial flaps

2008

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“…9,10 Also, because the transverse rectus abdominis muscle is included in the flap of the pedicled TRAM flap, there is a higher possibility of donor complications, such as abdominal wall weakness, than for the free TRAM flap, which uses the deep inferior epigastric vessel perforator. 11,12 The "supercharge" concept was introduced to augment the blood flow of the pedicled TRAM flap. Even when the pedicled TRAM flap is used, the deep inferior epigastric artery is harvested, and it is then connected to the recipient vessel to increase the amount of the flap's blood flow.…”

Section: Discussionmentioning

confidence: 99%

Use of Internal Mammary Vessel Perforator as a Recipient Vessel for Free TRAM Breast Reconstruction

Park

Lee

Chung

et al. 2003

Annals of Plastic Surgery

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Breast reconstruction is a cosmetically critical procedure for women and it must be undertaken to balance the shape, size, and position of the breast with the other breast. Since the first introduction of the free abdominoplasty flap in 1979, the transverse rectus abdominis musculocutaneous (TRAM) flap technique has been a widely accepted method of breast reconstruction after mastectomy. In breast reconstruction with a free flap, the selection of suitable recipient vessels is the critical decision to be made by the surgeon. The most common recipient vessel for free flap breast reconstruction is the axillary system. However, when used as a recipient, the axillary system may limit flap movement and flexibility in breast shaping. The use of the internal mammary vessels as a recipient site attains ideal breast symmetry. However, the technique requires partial rib resection and eliminates the opportunity for a potential coronary artery bypass graft, which requires the internal mammary artery. Based on these considerations, the selection of suitable recipient vessels constitutes an important requirement for successful free tissue transfer. The authors have performed breast reconstruction with the TRAM flap anastomosed to the internal mammary perforator vessel and conclude that these perforators could be useful as recipient vessels, especially in the case of immediate breast reconstruction with the free TRAM flap.

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“…Supermicrosurgery and hyaluronic acid: Experimental feasability study of a new method Introduction Supermicrosurgery is a technique for anastomosis of vessels of less than 0.8 mm in diameter that has aroused renewed interest on account of its potential clinical applications [1][2][3]. Perspectives for new therapeutic strategies in a wide variety of areas [3][4][5][6][7] (hand surgery, lymphedema treatment, tissue transfers from perforator to perforator, etc.)…”

Section: Original Articlementioning

confidence: 99%