Please use this identifier to cite or link to this item: http://hdl.handle.net/11434/322
Title: Stacked abdominal flap for unilateral breast reconstruction
Epworth Authors: Wasiak, Jason
Other Authors: Murray, Alexandra
Rozen, Warren Matthew
Ferris, Scott
Grinsell, Damien
Keywords: Unilateral Breast Reconstruction
DIEP
Microsurgical Breast Reconstruction
Plastic Surgery
Burns
Mammaplasty
Surgery, Plastic
Burns-Therapy
Abdominal Flap
Single Pedicle Flap
Stacked Double Pedicle Flap
Stacked Abdominal Flap
Deep Inferior Epigastric
Superficial Inferior Epigastric
Epworth Radiation Oncology, Melbourne, Victoria, Australia
Issue Date: Mar-2015
Publisher: Thieme
Citation: J Reconstr Microsurg. 2015 Mar;31(3):179-86
Abstract: BACKGROUND: The abdominal flap can be used in a stacked, double-pedicle configuration for unilateral breast reconstruction. Aided by preoperative mapping, this is a good option when a single-pedicle flap is deemed unsuitable. We present reliable outcomes using the stacked flap and a logical classification system for its use. METHODS: From 2008 to 2013, 18 patients underwent a stacked abdominal flap for unilateral breast reconstruction. Flaps utilized deep inferior epigastric (D) and superficial inferior epigastric (S) pedicle combinations. Preoperative computed tomography angiogram was performed on all patients. Medical records were reviewed for complications and clinical data, and a thorough clinical evaluation was performed on all patients at follow-up. Flaps were all double-pedicled, with the secondary pedicle anastomosed onto the primary pedicle (type 1 to 3) or onto a second recipient vessel (type 4). Flaps were then classified into groups, based on pedicle dominance and intraflap anastomosis. RESULTS: Twelve reconstructions were immediate and six delayed. Mean operative time was 7 hours, the most frequently used configuration being a type 1 DD, that is, secondary pedicle (D) anastomosed end-to-end onto the superior continuation of the primary pedicle (D). Average hospital stay was 6 days. There were no flap losses and minimal complications, and mean follow-up was 20 months. CONCLUSION: Use of this flap poses a greater challenge to the microsurgical breast reconstruction. We demonstrate its reliable use in women deemed unsuitable for a single-pedicle flap. Our structured system clarifies vascular options, and preoperative perforator mapping tools are essential to the success of this technique.
URI: http://hdl.handle.net/11434/322
DOI: 10.1055/s-0034-1390165
PubMed URL: http://www.ncbi.nlm.nih.gov/pubmed/25259672
ISSN: 0743-684X
Journal Title: Journal of Reconstructive Microsurgery
Type: Journal Article
Affiliated Organisations: Plastic Surgery Department, St Vincent's Hospital, Fitzroy, Victoria, Australia
Victorian Adult Burns Service and School of Public Health and Preventive Medicine, Monash University
The Alfred Hospital, Commercial Road, Melbourne, Victoria, Australia
Plastic Surgery Department, St Vincent's Private, East Melbourne, Victoria, Australia
Plastic Surgery Department, Western Hospital, Gordon Street, Footscray, Victoria, Australia
Type of Clinical Study or Trial: Retrospective studies
Appears in Collections:Radiation Oncology

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