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J Reconstr Microsurg 2017; 33(08): 557-562
DOI: 10.1055/s-0037-1603351
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Time and Speed of Vascular Pedicle Dissection in Deep Inferior Epigastric Artery Perforator Flap Elevation

Ji Hong Yim
1   Department of Plastic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea
,
Yeon Hoon Lee
1   Department of Plastic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea
,
Young Chul Kim
1   Department of Plastic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea
,
Eun Key Kim
1   Department of Plastic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea
,
Taik Jong Lee
1   Department of Plastic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea
,
Jiyoung Yun
2   Department of Plastic and Reconstructive Surgery, Inje University Busan Paik Hospital, Busan, Korea
,
Jin Sup Eom
1   Department of Plastic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea
› Author Affiliations
Further Information

Publication History

01 January 2017

17 April 2017

Publication Date:
30 May 2017 (online)

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Abstract

Background Breast reconstruction using deep inferior epigastric artery perforator (DIEP) free flap is widely used because of the advantages of minimizing donor-site morbidity, but it requires technical competency in vascular dissection. This study evaluated the influence of patient factors and vascular status on the time and speed of dissection of the vascular pedicle.

Methods DIEP free flap procedures were performed in 49 patients assigned to immediate or delayed reconstruction groups. Factors that significantly influenced the time required and the speed of dissection were evaluated.

Results The average total dissection time was 55.9 minutes (34.5 minutes for the intramuscular dissection and 21.4 minutes for the submuscular dissection). The dissection speed for the total vascular pedicle was 2.65 cm/10 minutes (1.71 cm/10 minutes for the intramuscular dissection and 4.30 cm/10 minutes for the submuscular dissection). The presence of a Pfannenstiel scar, length of the vascular pedicle in the intramuscular area, and the number of microclips used significantly correlated with the total dissection time.

Conclusion The length of the intramuscular pedicle, number of microclips used, and presence of a Pfannenstiel scar significantly correlated with the total dissection time of the vascular pedicle. An assessment prior to the surgery can reduce the time of operation and make it easier to elevate the flap.

Keywords

autologous breast reconstruction - deep inferior epigastric artery perforator free flap - dissection of vascular pedicle - dissection time and speed
 

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