Gravvanis Andreas, Niranjan Niri S
St. Andrews Centre for Plastic Surgery, Broomfield Hospital, Essex, UK.
Ann Plast Surg. 2008 Apr;60(4):395-7. doi: 10.1097/SAP.0b013e3180de60b7.
The deep inferior epigastric artery perforator (DIEAP) flap became the gold standard in breast reconstruction, but the dissection has a steep learning curve and the most demanding stage is the intramuscular dissection of the vascular pedicle. We present a retrograde technique to dissect the deep inferior epigastric pedicle that permits completion of the dissection and check the viability of the flap on one side before progressing to the other, which can be used as a lifeboat. We consider this technique reliable, safer than the conventional technique, and a brilliant training model in DIEAP flap harvesting.
腹壁下动脉穿支(DIEAP)皮瓣已成为乳房重建的金标准,但该解剖操作有一条陡峭的学习曲线,最具挑战性的阶段是血管蒂的肌内解剖。我们提出一种逆行技术来解剖腹壁下深血管蒂,该技术允许在一侧完成解剖并检查皮瓣的活力后再进行另一侧,这一侧可作为备用方案。我们认为该技术可靠,比传统技术更安全,是DIEAP皮瓣切取的优秀训练模型。