Anker, Alexandra M. and Prantl, Lukas and Strauss, Catharina and Brebant, Vanessa and Baringer, Magnus and Ruewe, Marc and Vykoukal, Jody and Klein, Silvan M. (2020) Clinical Impact of DIEP Flap Perforator Characteristics - A Prospective Indocyanine Green Fluorescence Imaging Study. JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY, 73 (8). pp. 1526-1533. ISSN 1748-6815, 1878-0539
Full text not available from this repository. (Request a copy)Abstract
Background: The question to what extent perfusion in deep inferior epigastric perforator (DIEP) flaps depends on specific perforator characteristics has been raised. Anatomical studies and previous clinical trials focussing on DIEP flap perfusion resulted in discrepancies. This prospective study investigates how perforator row, number and diameter affect DIEP flap microperfusion via Indocyanine Green (ICG) fluorescence angiography. Methods: The fractional weight of insufficiently perfused flap tissue in Zone 4 related to the total DIEP flap weight was measured based on ICG fluorescence angiography and defined as Zone 4 %. As a surrogate for overall DIEP flap perfusion, Zone 4 % was assessed according to the row, number and diameter of perforators included in the flap. Results: In 42 unilateral DIEP flap breast reconstructions, neither medial (33.6 +/- 14.2 %)/lateral perforator row (29.9 +/- 7.5 %, p = 0.683) nor the parameter perforator number (single perforator 31.5 +/- 14.4 %, two perforators 30.2 +/- 10.2 %, p = 0.727) had a statistically significant effect on flap tissue availability as measured via Zone 4 %. A negative correlative trend between perforator diameter and Zone 4 % (r = -0.096, p = 0.588) was observed. Conclusion: Zone 4 % provides a novel method for an objective assessment of DIEP flap perfusion. Medial/lateral row selection and other perforator properties (number, diameter) within the standard ranges, did not affect Zone 4 % as indicated by ICG fluorescence angiography. (C) 2020 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | BREAST RECONSTRUCTION; COMPUTED-TOMOGRAPHY; QUANTITATIVE-ANALYSIS; VASCULAR ANATOMY; PERFUSION ZONES; OPERATIVE TIME; CT ANGIOGRAPHY; ABDOMINAL-WALL; NECROSIS; NUMBER; Autologous breast reconstruction; free flap surgery; DIEP flap; flap perfusion; medial row perforator; lateral row perforator; perforator number; Indocyanine Green fluorescence angiography |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Plastische-, Hand- und Wiederherstellungschirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 17 Mar 2021 11:58 |
| Last Modified: | 17 Mar 2021 11:58 |
| URI: | https://pred.uni-regensburg.de/id/eprint/44126 |
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