Utility of the Free Deep Inferior Epigastric Perforator Flap in Chest Wall Reconstruction

Sullivan, Stephen R.; Truxillo, Terrence M.; Mann, Gary N.; Isik, F. Frank

doi:10.1111/j.1524-4741.2006.00362.x

Cited by 10 publications

(7 citation statements)

References 19 publications

(37 reference statements)

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“…large DIEP flaps have been used for reconstruction of the vagina, chest wall, inguinal region, scrotum, and lower extremities. [3][4][5]17,18 If a very large free DIEP flap is harvested, it is advisable to supercharge the arterial input by an additional anastomosis with the ipsilateral or contralateral superficial inferior epigastric artery or the inclusion of contralateral deep inferior epigastric vessels to the flap. 19 These maneuvers require extra microsurgery and expense.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Two Different Vascular Delay Methods in a Rat Cranial Epigastric Perforator Flap Model

Seyhan¹,

Deniz²,

Borman³

et al. 2010

Annals of Plastic Surgery

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The effectiveness of vascular delay in transverse rectus abdominis muscle flaps has been demonstrated in many studies. In deep inferior epigastric perforator flaps, however, the effectiveness of ligation of deep versus superficial epigastric vessels in producing delay is unclear. Using a rat model, we compared ligation of deep and superficial vessels with each other and with a (nondelayed) control group (n = 10). One vascular delay group (n = 10) had ligation of the contralateral cranial epigastric vessels (homolog to the human deep inferior epigastric vessels); the other (n = 10) had ligation of contralateral superficial inferior epigastric vessels. One week later, cranial epigastric perforator flap elevation was performed. Both vascular techniques were effective in producing delay, and there was no statistically significant difference between the 2 groups. Ligation of superficial inferior epigastric vessels, deep inferior epigastric vessels, or both, at least 1 week prior to the deep inferior epigastric perforator flap elevation may increase the usable skin paddle area in humans.

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Section: Discussionmentioning

confidence: 99%

Comparison of Two Different Vascular Delay Methods in a Rat Cranial Epigastric Perforator Flap Model

Seyhan¹,

Deniz²,

Borman³

et al. 2010

Annals of Plastic Surgery

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“…Sternal, lateral, and thoracoabdominal are the most common locations for tumor resections. 1 A forequarter amputation with resection of the shoulder girdle as well as ribs is performed rarely. 2 In a one-stage procedure with tumor resection and primary reconstruction, no compromise regarding adequate radicality is allowed.…”

Section: Surgical Concept (Procedure)mentioning

confidence: 99%

Microsurgical Chest Wall Reconstruction After Oncologic Resections

Sauerbier

Dittler

Kreutzer

2011

Seminars in Plastic Surgery

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Defect reconstruction after radical oncologic resection of malignant chest wall tumors requires adequate soft tissue reconstruction with function, stability, integrity, and an aesthetically acceptable result of the chest wall. The purpose of this article is to describe possible reconstructive microsurgical pathways after full-thickness oncologic resections of the chest wall. Several reliable free flaps are described, and morbidity and mortality rates of patients are discussed.

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“…One of the simple ways to close the wound is a bilateral local skin advancement flap in which the skin and subcutaneous fat is undermined superiorly toward the clavicle and inferiorly toward the abdomen [1,2]. Several procedures have been reported including skin grafts, fasciocutaneous flaps, myocutaneous flaps and perforator flaps when the skin defect is difficult to close by primary or undermining [1][2][3][4][5][6][7]. Among these procedures, skin graft is a simple, less invasive and less time-consuming procedure compared to the other procedures; however, an additional scar at the donor site is unavoidable [1,2,8].…”

Section: Introductionmentioning

confidence: 99%

Skin grafting utilizing a skin of lateral thoracic area for chest wall reconstruction in patient who underwent mastectomy for locally advanced breast cancer

et al. 2020

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Locally advanced breast cancer sometimes results in a large chest wall defect at mastectomy. When closing the wound horizontally, the skin tension is usually severe in the middle of the wound, while the skin of the lateral area tends to make a dog-ear deformity. Triangle technique is a procedure to prevent the dog ear in which the skin and subcutaneous fat of the axilla are cut into an equilateral triangle. Herein, we present a case of breast cancer who underwent a mastectomy and closed the wound with a skin graft by utilizing the skin removed from lateral thoracic area using triangle technique. An 85-year-old female visited our institution complaining about the mass on her right breast. Preoperative images showed a 10 cm-sized mass with suspicious axillary and mediastinal lymph nodes swelling. A biopsy revealed a hormone receptor-negative, HER2positive invasive ductal carcinoma. A mastectomy and axillary lymph node sampling were performed for a local control as the tumor did not respond to four cycles of triweekly trastuzumab combined with S-1. After a transverse elliptical incision, a skin of the lateral thoracic area was harvested using triangle technique. As the middle of the wound had excessive closing tension, the skin was grafted on the defect. After 10 day fixation by a tie-over dressing, the wound healed without complications. This procedure is a simple method for closing a large defect after mastectomy preventing both the dog-ear deformity and a new wound scarring of a donor site.

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Utility of the Free Deep Inferior Epigastric Perforator Flap in Chest Wall Reconstruction

Cited by 10 publications

References 19 publications

Comparison of Two Different Vascular Delay Methods in a Rat Cranial Epigastric Perforator Flap Model

Comparison of Two Different Vascular Delay Methods in a Rat Cranial Epigastric Perforator Flap Model

Microsurgical Chest Wall Reconstruction After Oncologic Resections

Skin grafting utilizing a skin of lateral thoracic area for chest wall reconstruction in patient who underwent mastectomy for locally advanced breast cancer

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