Bettex Q, Jaloux C, Abellan Lopez M, Casanova D, Bertrand B, Philandrianos C
Service de chirurgie plastique, reconstructrice et esthetique, hôpital de la Conception, Assistance publique-Hôpitaux de Marseille, 147, boulevard Baille, 13005 Marseille, France.
Service de chirurgie plastique, reconstructrice et esthetique, hôpital de la Conception, Assistance publique-Hôpitaux de Marseille, 147, boulevard Baille, 13005 Marseille, France.
Ann Chir Plast Esthet. 2019 Apr;64(2):199-203. doi: 10.1016/j.anplas.2018.08.007. Epub 2018 Sep 27.
Breast reconstruction by abdominal flap has evolved to ensure minimal donor-site morbidity with the description of Deep Inferior Epigastric artery Perforator flap (DIEP flap). Being of the same thickness and the same surface, the Superficial Inferior Epigastric Artery flap (SIEA flap) does not require, for it harvesting, to open the abdominal fascia or to dissect through the muscles minimizing again donor-site sequelae. However, it is little used because of the variability of its vascularization and a higher failure rate than the DIEP in the literature. We believe that it is reasonable, in some cases, to harvest a SIEA flap instead of DIEP flap in mammary reconstruction. We present a technical note explaining our operative strategy for reliably taking a SIEA when the caliber of the vessels allows.
随着腹壁下深动脉穿支皮瓣（DIEP皮瓣）的出现，通过腹部皮瓣进行乳房重建已发展到可确保供区并发症降至最低。腹壁下浅动脉皮瓣（SIEA皮瓣）厚度和表面相同，在采集时无需打开腹筋膜或解剖肌肉，再次将供区后遗症降至最低。然而，由于其血管化的变异性以及文献中报道的比DIEP更高的失败率，它很少被使用。我们认为，在某些情况下，在乳房重建中采集SIEA皮瓣而非DIEP皮瓣是合理的。我们给出一份技术说明，解释当血管管径允许时可靠获取SIEA皮瓣的手术策略。
