Gravvanis Andreas, Kakagia Despoina, Samouris George, Galani Eleni, Tsoutsos Dimosthenis
Department of Plastic Surgery, Microsurgery and Burn Center "J. Ioannovich," General State Hospital of Athens "G. Gennimatas," Athens, Greece.
J Reconstr Microsurg. 2016 Jun;32(5):366-70. doi: 10.1055/s-0036-1581076. Epub 2016 Apr 13.
Purpose The dual-plane deep inferior epigastric perforator (DIEP) flap inset technique is herein presented with tips for optimizing the aesthetic outcome in delayed autologous breast reconstruction after radiation therapy. Patients and Methods A total of 42 women who underwent microsurgical reconstruction with a free DIEP flap participated in this prospective study. The flap was inset in a dual plane lying behind the pectoralis major at the upper pole and in front of the muscle at the lower pole of the reconstructed breast. Results The dual-plane flap inset resulted in natural transition from native and reconstructed tissues, excellent scar quality, optimal outline of the breast, and overall breast appearance. Moreover, dual-plane reconstruction was associated with constantly high patient satisfaction without wearing brassiere due to fullness of the upper pole and minimal ptosis with time. Conclusion The dual-plane DIEP flap inset results in optimal scar quality, breast shape, and fullness of the upper pole, resulting in high patient satisfaction.
目的 本文介绍双平面腹壁下深动脉穿支（DIEP）皮瓣植入技术，并给出在放疗后延迟自体乳房重建中优化美学效果的技巧。患者与方法 共有42例接受游离DIEP皮瓣显微外科重建的女性参与了这项前瞻性研究。皮瓣植入双平面，在上极位于胸大肌后方，在重建乳房下极位于胸大肌前方。结果 双平面皮瓣植入使天然组织与重建组织自然过渡，瘢痕质量优良，乳房轮廓最佳，整体乳房外观良好。此外，双平面重建与患者持续高满意度相关，由于上极丰满且随时间推移下垂最小，无需佩戴胸罩。结论 双平面DIEP皮瓣植入可实现最佳的瘢痕质量、乳房形状和上极丰满度，从而使患者满意度较高。
