Document Detail


The perforator angiosome: a new concept in the design of deep inferior epigastric artery perforator flaps for breast reconstruction.
MedLine Citation:
PMID:  19582823     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The previously described "perfusion zones" of the abdominal wall vasculature are based on filling of the deep inferior epigastric artery (DIEA) and all its branches simultaneously. With the advent of the DIEA perforator flap, only a single or several perforators are included in supply to the flap. As such, a new model for abdominal wall perfusion has become necessary. The concept of a "perforator angiosome" is thus explored. METHODS: A clinical and cadaveric study of 155 abdominal walls was undertaken. This comprised the use of 10 whole, unembalmed cadaveric abdominal walls for angiographic studies, and 145 abdominal wall computed tomographic angiograms (CTAs) in patients undergoing preoperative imaging of the abdominal wall vasculature. The evaluation of the subcutaneous branching pattern and zone of perfusion of individual DIEA perforators was explored, particularly exploring differences between medial and lateral row perforators. RESULTS: Fundamental differences exist between medial row and lateral row perforators, with medial row perforators larger (1.3 mm vs. 1 mm) and more likely to ramify in the subcutaneous fat toward the contralateral hemiabdomen (98% of cases vs. 2% of cases). A model for the perfusion of the abdominal wall based on a single perforator is presented. CONCLUSION: The "perforator angiosome" is dependent on perforator location, and can mapped individually with the use of preoperative imaging.
Authors:
Warren M Rozen; Mark W Ashton; Cara Michelle Le Roux; Wei-Ren Pan; Russell J Corlett
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Microsurgery     Volume:  30     ISSN:  1098-2752     ISO Abbreviation:  Microsurgery     Publication Date:  2010  
Date Detail:
Created Date:  2010-01-11     Completed Date:  2010-05-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309230     Medline TA:  Microsurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1-7     Citation Subset:  IM    
Affiliation:
Department of Anatomy and Cell Biology, The University of Melbourne, Jack Brockhoff Reconstructive Plastic Surgery Research Unit, Parkville, Victoria, 3050, Australia. warrenrozen@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Abdominal Fat / blood supply,  radiography
Abdominal Muscles / blood supply,  radiography
Abdominal Wall / blood supply*,  surgery
Adult
Aged
Aged, 80 and over
Angiography
Cadaver
Cohort Studies
Epigastric Arteries*
Female
Humans
Male
Mammaplasty*
Microcirculation
Middle Aged
Surgical Flaps / blood supply*
Tomography, X-Ray Computed

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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