Decision Making in Double-Pedicled DIEP and SIEA Abdominal Free Flap Breast Reconstructions: An Algorithmic Approach and Comprehensive Classification

[摘要] IntroductionThe deep inferior epigastric artery perforator free flap is the gold standard for autologous breast reconstruction. However, using a single vascular pedicle may not yield sufficient tissue in patients with midline scars or insufficient lower abdominal pannus. Double-pedicled free flaps overcome this problem using different vascular arrangements to harvest the entire lower abdominal flap. The literature is, however, sparse regarding technique selection. We therefore reviewed our experience in order to formulate an algorithm and comprehensive classification for this purpose.

[学科分类] 外科医学

[关键词] Bipedicled free flaps;double-pedicle free flaps;stacked free flaps;breast reconstruction;abdominal free flaps;DIEP and SIEA breast free flaps;intra-flap and extra-flap microvascular anastomoses;rib sparing internal mammary vessel exposure