Neurovascular anatomy of the deep inferior epigastric perforator flap for breast reconstruction
Tansatit, T.; Chokrungvaranont, P.; Sanguansit, P.; Wanidchaphloi, S.
Journal of the Medical Association of Thailand 89(10): 1630-1640
2006
ISSN/ISBN: 0125-2208 PMID: 17128837 Document Number: 2650
Objective: To find out the most suitable perforator and cutaneous nerve for strategic design of the deep inferior epigastric perforator (DIEP) flap.Material and Method: The characteristics of the pedicles, perforators, intercostal nerves and the relationship between nerves and vessels in DIEP flaps were studied in 31 formalin-preserved cadavers.Results: Four hundred and five perforator vessels were divided into three vertical rows. These perforators were mostly contained in the medial row (45.4%), the average size of the perforators in the lateral row was the largest (1.0 +/- 0.3 mm). The largest perforators (1.4 +/- 0.3 mm) were mostly located within I cm horizontally from the umbilicus. Lateral row perforators, usually rectilinear course (82.7%), traveled with nerves from the beginning. Whereas, the perforators in the medial row usually coursed obliquely (86.4%) and were not related to nerves initially, they joined before piercing the rectus sheath.Conclusion: The present findings indicate that it would be more beneficial to use the lateral row perforators.
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