Journal of Plastic, Reconstructive & Aesthetic Surgery
Volume 63, Issue 4 , Pages 648-654 , April 2010

Performing two DIEP flaps in a working day: an achievable and reproducible practice

  • Rafael Acosta

      Affiliations

    • Department of Plastic Surgery, Uppsala Clinic Hospital, Uppsala, 75185, Sweden
    • Corresponding Author InformationCorresponding author. Tel.: +46 18611 0000; fax: +46 1829 1001.
    • ,
  • Morteza Enajat

      Affiliations

    • Department of Plastic Surgery, Uppsala Clinic Hospital, Uppsala, 75185, Sweden
    • ,
  • Warren M. Rozen

      Affiliations

    • Jack Brockhoff Reconstructive Plastic Surgery Research Unit, The University of Melbourne, Victoria, Australia
    • ,
  • Jeroen M. Smit

      Affiliations

    • Department of Plastic Surgery, Uppsala Clinic Hospital, Uppsala, 75185, Sweden
    • Department of Plastic Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands
    • ,
  • Marcus J.D. Wagstaff

      Affiliations

    • Department of Plastic Surgery, University Hospital of Sheffield, Sheffield, United Kingdom
    • ,
  • Iain S. Whitaker

      Affiliations

    • Department of Plastic, Reconstructive and Burn Surgery, The Welsh National Plastic Surgery Unit, The Morriston Hospital, Swansea, United Kingdom
    • ,
  • Thorir Audolfsson

      Affiliations

    • Department of Plastic Surgery, Uppsala Clinic Hospital, Uppsala, 75185, Sweden

Received 18 October 2008 ,Accepted 5 January 2009.

References 

  1. Guerra AB, Metzinger SE, Bidros RS, et al. Bilateral breast reconstruction with the deep inferior epigastric perforator (DIEP) flap: an experience with 280 flaps. Ann Plast Surg. 2004;52:246–252
  2. Allen RJ. DIEP versus TRAM for breast reconstruction. Plast Reconstr Surg. 2003;111:2478
  3. Allen RJ, Treece P. Deep inferior epigastric perforator flap for breast reconstruction. Ann Plast Surg. 1994;32:32–38
  4. Blondeel PN. One hundred free DIEP flap breast reconstructions: a personal experience. Br J Plast Surg. 1999;52:104–111
  5. Allen RJ. Comparison of the costs of DIEP and TRAM flaps. Plast Reconstr Surg. 2001;108:2165
  6. Blondeel N, Vanderstraeten GG, Monstrey SJ, et al. The donor site morbidity of free DIEP flaps and free TRAM flaps for breast reconstruction. Br J Plast Surg. 1997;50:322–330
  7. Nahabedian MY, Momen B, Galdino G, et al. Breast Reconstruction with the free TRAM or DIEP flap: patient selection, choice of flap, and outcome. Plast Reconstr Surg. 2002;110:466–475
  8. Nahabedian MY, Tsangaris T, Momen B. Breast reconstruction with the DIEP flap or the muscle-sparing (MS-2) free TRAM flap: is there a difference?. Plast Reconstr Surg. 2005;115:436–444
  9. Hamdi M, Weiler-Mithoff EM, Webster MHC. Deep inferior epigastric perforator flap in breast reconstruction: experience with the first 50 flaps. Plast Reconstr Surg. 1999;103:86–95
  10. Garvey PB, Buchel EW, Pockaj BA, et al. DIEP and pedicled TRAM flaps: a comparison of outcomes. Plast Reconstr Surg. 2006;117:1711–1719
  11. Smit JM, Dimopoulou A, Liss AG, et al. Preoperative CT angiography reduces surgery time in perforator flap reconstruction. J Plast Reconstr Aesthet Surg. 2008;[Epub ahead of print]
  12. Smit JM, Whitaker IS, Liss AG, et al. Post operative monitoring of microvascular breast reconstructions using the implantable Cook-Swartz Doppler system: a study of 145 probes & technical discussion. J Plast Reconstr Aesthet Surg. 2008;[Epub ahead of print]
  13. Whitaker IS, Smit JM, Acosta R. A simple method of implantable Doppler cuff attachment: experience in 150 DIEP breast reconstructions. J Plast Reconstr Aesthet Surg. 2008;61:1251–1252
  14. Zeebregts C, Acosta R, Bölander L, et al. Clinical experience with non-penetrating vascular clips in free-flap reconstructions. Br J Plast Surg. 2002;55:105–110
  15. Nahabedian MY, Dooley W, Singh N, et al. Contour abnormalities of the abdomen after breast reconstruction with abdominal flaps: the role of muscle preservation. Plast Reconstr Surg. 2002;109:91–101
  16. Futter CM, Webster MH, Hagen S, et al. A retrospective comparison of abdominal muscle strength following breast reconstruction with a free TRAM or DIEP flap. Br J Plast Surg. 2000;53:578–583
  17. Kroll SS. Fat necrosis in free transverse rectus abdominis myocutaneous and deep inferior epigastric perforator flaps. Plast Reconstr Surg. 2000;106:576–583
  18. Arnez ZM, Khan U, Pogorelec D, et al. Rational selection of flaps from the abdomen in breast reconstruction to reduce donor site morbidity. Br J Plast Surg. 1999;52:351–354
  19. Rozen WM, Ashton MW, Grinsell D, et al. Establishing the case for CT angiography in the preoperative imaging of perforators for DIEA perforator flaps. Microsurgery. 2008 Jul 8;28:227–232
  20. Keller A. Fat necrosis in free rectus abdominis and deep inferior epigastric perforator flaps. Plast Reconstr Surg. 2001;107:1611–1612
  21. Elliott LF, Seify H, Bergey P. The 3-Hour Muscle-Sparing Free TRAM Flap: safe and effective treatment review of 111 consecutive free TRAM flaps in a private practice setting. Plast Reconstr Surg. 2007;120:27
  22. Rozen WM, Anavekar NS, Ashton MW, et al. Does the preoperative imaging of perforators with CT angiography improve operative outcomes in breast reconstruction?. Microsurgery. 2008;28:516–523
  23. Rozen WM, Phillips TJ, Ashton MW, et al. Preoperative imaging for DIEA perforator flaps: a comparative study of Computed Tomographic Angiography and Doppler ultrasound. Plast Reconstr Surg. 2008;121:9–16
  24. Phillips TJ, Stella DL, Rozen WM, et al. Abdominal wall CT angiography: a detailed account of a newly established preoperative imaging technique. Radiology. 2008;249:32–44
  25. Morecraft RJ, Blair WF, Maynard JA. Suture extrusion in small arteries and veins. Scand J Plast Reconstr Surg Hand Surg. 1988;22:121–126
  26. Zeebregts CJ, van den Dungen JJ, Kalicharan D, et al. Nonpenetrating vascular clips for small-caliber anastomosis. Microsurgery. 2000;20:131–138

PII: S1748-6815(09)00069-2

doi: 10.1016/j.bjps.2009.01.015

Journal of Plastic, Reconstructive & Aesthetic Surgery
Volume 63, Issue 4 , Pages 648-654 , April 2010

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