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Semin Plast Surg 2002; 16(1): 007-018
DOI: 10.1055/s-2002-22675
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Deep Inferior Epigastric Perforator Flap Breast Reconstruction

Frank J. DellaCroce, Robert J. Allen, Scott K. Sullivan
  • Department of Surgery, Division of Plastic Surgery, Louisiana State University Health Sciences Center, New Orleans, LA
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Publication History

Publication Date:
22 March 2002 (online)

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ABSTRACT

Breast reconstruction is a critical part of the overall care plan for patients faced with a diagnosis of breast cancer and a plan that includes mastectomy. The evolution of reconstructive techniques has resulted in the development of procedures that restore form and a sense of wholeness without excessive morbidity. Perforator flaps best represent this state of the art in breast reconstructive surgery. Tissue is replaced with like tissue giving a result that is durable and as near to a natural breast as possible. Sparing of the rectus abdominus musculature differentiates this procedure from other autogenous modalities such as the pedicled and free transverse rectus abdominus. The deep inferior epigastric artery perforator (DIEP) flap has been shown to be a safe, dependable, and reproducible method of breast reconstruction. In addition to maintaining abdominal wall strength and minimizing the risk of subsequent hernia, the DIEP flap breast reconstruction patient has been shown to enjoy a shorter recovery period with less postoperative pain and a resultant high rate of satisfaction.

KEYWORD

Breast cancer - free flap - breast reconstruction - perforator flap

REFERENCES

  • 1 Mentor Large Simple Trial (LST) and Saline Prospective Trial (SPS). Mentor Corporation, July 2000
  • 2 Kroll S S, Evans G, Reece R D. Comparison of resource costs between implant-based and TRAM flap breast reconstruction.  Plast Reconstr Surg . 1996;  97 364-372
    CrossrefPubMedGoogle Scholar
  • 3 Schneider W J, Hill H L, Brown R G. Latissimus dorsi myocutaneous flap for breast reconstruction.  Br J Plast Surg . 1977;  30 277-281
    CrossrefPubMedGoogle Scholar
  • 4 Fujino R, Harashina R, Enomoto K. Primary breast reconstruction after a standard radical mastectomy by free flap transfer.  Plast Reconstr Surg . 1976;  58 371-374
    Google Scholar
  • 5 Holmstrom H. The free abdominoplasty flap and its use in breast reconstruction.  Scand J Plast Reconstr Surg . 1979;  13 423-427
    CrossrefPubMedGoogle Scholar
  • 6 Hartrampf C R, Scheflan M, Black P W. Breast reconstruction with a transverse abdominal island flap.  Plast Reconstr Surg . 1982;  69 216-225
    CrossrefPubMedGoogle Scholar
  • 7 Hartrampf C R, Bennet G K. Autogenous tissue reconstruction in the mastectomy patient: a critical review of 300 patients.  Ann Surg . 1987;  205 508-519
    CrossrefPubMedGoogle Scholar
  • 8 Kroll S S, Evans G, Reece R D. Comparison of resource costs of free and conventional TRAM flap breast reconstruction.  Plast Reconstr Surg . 1996;  98 74-77
    CrossrefPubMedGoogle Scholar
  • 9 Baldwin B J, Schusterman M D, Miller M J. Bilateral breast reconstruction: conventional versus free TRAM.  Plast Reconstr Surg . 1994;  93 1410-1416
    CrossrefPubMedGoogle Scholar
  • 10 Zienowicz R J, May J W. Hernia prevention and aesthetic contouring of the abdomen following TRAM flap breast reconstruction by the use of polypropylene mesh.  Plast Reconstr Surg . 1995;  96 1346-1350
    PubMedGoogle Scholar
  • 11 Kroll S S, Marchi M. Comparison of strategies for preventing abdominal wall weakness after TRAM flap breast reconstruction.  Plast Reconstr Surg . 1992;  89 1045-1051
    CrossrefPubMedGoogle Scholar
  • 12 Kroll S S, Schusterman M A, Reece G P. Abdominal wall strength, bulging, and hernia after TRAM flap breast reconstruction.  Plast Reconstr Surg . 1995;  96 616-619
    CrossrefPubMedGoogle Scholar
  • 13 Mizgala C L, Hartrampf C R, Bennet G K. Assessment of the abdominal wall after pedicled TRAM flap surgery: 5 to 7 year follow-up of 150 consecutive patients.  Plast Reconstr Surg . 1994;  93 988-1002
    PubMedGoogle Scholar
  • 14 Kroll S S, Sharma S, Koutz C. Postoperative morphine requirements of free TRAM and DIEP flaps.  Plast Reconstr Surg . 2001;  107 338-341
    CrossrefPubMedGoogle Scholar
  • 15 Koshima I, Soeda S. Inferior epigastric artery skin flap without rectus abdominus muscle.  Br J Plast Surg . 1989;  42 645-648
    CrossrefPubMedGoogle Scholar
  • 16 Allen R J, Treece P. Deep inferior epigastric perforator flap for breast reconstruction.  Ann Plast Surg . 1994;  32 32-38
    Google Scholar
  • 17 Blondeel P N, Vanderstraeten G G, Monstrey S J. The donor site morbidity of free DIEP flaps and free TRAM flaps for breast reconstruction.  Br J Plast Surg . 1997;  50 322-330
    Google Scholar
  • 18 Padubidri A N, Yetman R, Browne E. Complications of post mastectomy breast reconstruction in smokers, ex-smokers, and non-smokers.  Plast Reconstr Surg . 2001;  107 342-349
    CrossrefPubMedGoogle Scholar
  • 19 Kroll S S. Necrosis of abdominoplasty and other secondary flaps after TRAM flap breast reconstruction.  Plast Reconstr Surg . 1994;  94 637-643
    PubMedGoogle Scholar
  • 20 Grotting J C, Urist M M, Maddox W A. Conventional TRAM flap versus free microsurgical TRAM flap for immediate breast reconstruction.  Plast Reconstr Surg . 1989;  83 828-841
    CrossrefPubMedGoogle Scholar