Halim Ahmad Sukari, Alwi Akmal Azim
From the Reconstructive Sciences Department, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
Ann Plast Surg. 2014 Aug;73(2):170-3. doi: 10.1097/SAP.0b013e318270704b.
The use of internal mammary perforators (IMPs) as recipient vessels in autologous free flap breast reconstruction has many additional benefits compared with the internal mammary or thoracodorsal vessels. Our goals were to analyze the characteristics of these vessels and to evaluate the reliability of using them in an Asian population.
Thirty-five consecutive patients were prospectively studied between November 2000 and December 2010. Twelve patients underwent muscle-sparing-2 transverse rectus abdominis musculocutaneous flap, and 23 had deep inferior epigastric perforator flap reconstructions.
Internal mammary perforator vessels were used in 29 patients (83%). Most (75%) of the vessels were located in the subcutaneous plane, and 85% were in the second and third intercostal spaces. There were significantly more usable IMP vessels in the immediate than in the delayed reconstructions (P = 0.049). All the flaps in the study were successful despite 1 requiring emergency re-exploration because of venous congestion.
Most of the IMP vessels are small; however, they are still reliable and safe for use as recipient vessels in selected Asian patients. Most are located in the subcutaneous plane, which further facilitates dissection and also reduces recipient-site morbidity.
与胸廓内血管或胸背血管相比，在自体游离皮瓣乳房重建中使用胸廓内穿支血管（IMPs）有许多额外的益处。我们的目标是分析这些血管的特征，并评估在亚洲人群中使用它们的可靠性。
2000年11月至2010年12月对35例连续患者进行前瞻性研究。12例患者接受保留肌肉的2型横行腹直肌肌皮瓣手术，23例患者进行腹壁下深穿支皮瓣重建。
29例患者（83%）使用了胸廓内穿支血管。大多数血管（75%）位于皮下平面，85%位于第二和第三肋间间隙。即刻重建中可用的IMPs血管明显多于延迟重建（P = 0.049）。尽管有1例因静脉淤血需要紧急再次探查，但本研究中的所有皮瓣均成功。
大多数IMPs血管较小；然而，在选定的亚洲患者中，它们作为受区血管使用仍然可靠且安全。大多数位于皮下平面，这进一步便于解剖，也降低了受区的发病率。
