How long are fasciocutaneous flaps dependant on their vascular pedicle: A unique case of SIEA flap survival

Morteza Enajat, Warren M. Rozen, Iain S. Whitaker, Thorir Audolfsson, Rafael Acosta*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

Background: While it has long been held that muscle flaps maintain their dependency on their vascular pedicle for the long term, fasciocutaneous flaps have been less well investigated. Recent studies of the deep inferior epigastric artery perforator (DIEP) flap have suggested that these flaps may maintain long term dependence on their vascular pedicles for survival. There is no literature concerning these effects in the superficial inferior epigastric artery (SIEA) flap. Case report: We describe a unique case in which the pedicle of a superficial inferior epigastric artery (SIEA) flap for breast reconstruction was avulsed 11 days postoperatively, with the flap surviving on its inferior wound edge alone. Conclusion: Fasciocutaneous flaps may lose dependency on their vascular pedicles in the short term following transfer, developing alternative pathways for vascular supply and ultimately survival. A conservative approach early in the course of flap compromise due to perforator ligation or avulsion, in cases where immediate re-anastomosis may not be feasible, is thus supported.

Original languageEnglish
Pages (from-to)e347-e350
JournalJournal of Plastic, Reconstructive and Aesthetic Surgery
Volume63
Issue number4
DOIs
Publication statusPublished - Apr 2010

Other keywords

  • Blood supply
  • Breast reconstruction
  • DIEP flap
  • Dominant
  • Perforator flap
  • Vascular pedicle

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