Sim Nadia Hui Shan, Wong Allen Wei-Jiat
Plastic, Reconstructive & Aesthetic Surgery Service, Sengkang General Hospital, 110 Sengkang E Way, Singapore 544886, Singapore.
J Surg Case Rep. 2025 Jun 18;2025(6):rjaf408. doi: 10.1093/jscr/rjaf408. eCollection 2025 Jun.
This study aims to identify a novel mega-flap from the abdominal region. The flap is an extension of the bipedicled DIEP to incorporate the bilateral superficial circumflex iliac perforator (SCIP) and external pudendal arterial systems. These arise from the common femoral artery, hence termed "The Three Gorges" flap. We utilized a novel indocyanine green fluorescence angiography method to evaluate the perfusion of this flap solely via the bilateral DIEP pedicles. Anatomical dissection of three cadavers was performed to map the perfusion zone of the flap via bilateral DIEP pedicles. Indocyanine green fluorescence angiography was employed to capture the perfusion in real time. The SCIP and superficial external pudendal systems can be perfused by the DIEP pedicle. A novel mega-flap based on three tributaries from bilateral DIEP, SCIP, and superficial external pudendal arterial systems can be supplied by bilateral DIEP pedicles.
本研究旨在从腹部区域识别一种新型的超大皮瓣。该皮瓣是双蒂腹壁下动脉穿支皮瓣（DIEP）的延伸，纳入了双侧旋髂浅动脉穿支（SCIP）和阴部外动脉系统。这些动脉起源于股总动脉，因此称为“三峡”皮瓣。我们采用一种新型的吲哚菁绿荧光血管造影方法，仅通过双侧DIEP蒂来评估该皮瓣的灌注情况。对三具尸体进行解剖，以绘制通过双侧DIEP蒂的皮瓣灌注区域。采用吲哚菁绿荧光血管造影实时捕捉灌注情况。SCIP和阴部外浅动脉系统可由DIEP蒂进行灌注。基于双侧DIEP、SCIP和阴部外浅动脉系统的三条分支的新型超大皮瓣可由双侧DIEP蒂供血。
