Immediate Breast Reconstruction with DIEP Free Flap

Kim,  Jun Hyung; Park,  Ji Ung; Cho,  Sang Hun; Eo,  Su Rak

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Original Article

Journal of the Korean Society for Surgery of the Hand 2008;17(2):94-100.
Published online November 30, 2008.

Immediate Breast Reconstruction with DIEP Free Flap

Jun Hyung Kim, M.D., Ji Ung Park, M.D., Sang Hun Cho, M.D., Ph.D., Su Rak Eo, M.D., Ph.D.

Department of Plastic and Reconstructive Surgery Dongguk University International Hospital, Korea. sreo@duih.org

심부하복벽 천공지 유리피판을 이용한 즉시 유방재건술

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Abstract

  In the past decade, there has been increasing breast reconstructions after mastectomy, and the abdomen has been the gold standard for donor site. TRAM (transverse rectus abdominis myocutaneous), MSTRAM (muscle sparing transverse rectus abdominis myocutaneous), DIEP (deep inferior epigastric artery perforator), SIEA (superficial inferior epigastric artery) flap has been widely used nowadays. Among them, DIEP free flap spares the whole rectus abdominis muscle and anterior rectus sheath resulting in decreased donor site morbidity.
  Between March of 2006 and February of 2008, six patients had undergone immediate breast reconstructions using DIEP free flap. The mean age of patients was 48.5 years. All patients had unilateral breast reconstructions. We dissected two perforators which were included in the unilateral pedicle. Thoracodorsal artery and its venae comitantes were chosen as recipient vessels. For venous anastomosis, we used the GEM Microvascular Anastomotic Coupler System (Synovis Micro Companies Alliance, Inc., Birmingham, Ala.) in four cases. All flaps were survived completely except one who showed fatty abdomen in old age. She showed repetitive vascular spasm intraoperatively. None of the patients had abdominal hernia, bulge or weakness.
  We believe that DIEP free flap provides a reliable method for autologous breast reconstruction if the patients are selected appropriately and performed by a skillful surgeon.

Key Words: Breast reconstruction, Deep inferior epigastric artery perforator free flap

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