The Impact of Perforator Number on Deep Inferior Epigastric Perforator Flap Breast Reconstruction

BackgroundPerforator flaps minimize abdominal site morbidity during autologous breast reconstruction. The purpose of this study was to assess whether the number of perforators harvested influences the overall deep inferior epigastric perforator (DIEP) flap survival and flap-related complications. MethodsA retrospective review was performed of all DIEP flaps performed at the Hospital of the University of Pennsylvania from 2006 to 2011. The outcomes assessed included flap loss and major complications. We compared flaps by the number of total perforators (1-4) and then carried out a subgroup analysis comparing flaps with one perforator to flaps with multiple perforators. Lastly, we conducted a post-hoc analysis based on body mass index (BMI) categorization. ResultsThree hundred thirty-three patients underwent 395 DIEP flaps. No significant differences were noted in the flap loss rate or the overall complications across perforator groups. However, the subgroup analysis revealed significantly higher rates of fat necrosis in the case of one-perforator flaps than in the case of multiple-perforator flaps (10.2% vs. 3.1%, P=0.009). The post-hoc analysis revealed a significant increase in the flap loss rate with increasing BMI (<30=2.0%, 30-34.9=3.1%, 35-39.9=3.1%, >40=42.9%, P<0.001) in the DIEP flaps, but no increase in fat necrosis. ConclusionsThis study demonstrates that the number of perforators does not impact the rate of flap survival. However, the rate of fat necrosis may be significantly higher in DIEP flaps based on a single perforator. Multiple perforators should be utilized if possible to decrease the risk of fat necrosis.

Standort
Deutsche Nationalbibliothek Frankfurt am Main
Umfang
Online-Ressource
Sprache
Englisch

Erschienen in
The Impact of Perforator Number on Deep Inferior Epigastric Perforator Flap Breast Reconstruction ; volume:41 ; number:01 ; year:2014 ; pages:63-70
Archives of Plastic Surgery ; 41, Heft 01 (2014), 63-70

Beteiligte Personen und Organisationen
Grover, Ritwik
Nelson, Jonas A.
Fischer, John P.
Kovach, Stephen J.
Serletti, Joseph M.
Wu, Liza C.

DOI
10.5999/aps.2014.41.1.63
URN
urn:nbn:de:101:1-2022061611045149513529
Rechteinformation
Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
Letzte Aktualisierung
15.08.2025, 07:29 MESZ

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Beteiligte

  • Grover, Ritwik
  • Nelson, Jonas A.
  • Fischer, John P.
  • Kovach, Stephen J.
  • Serletti, Joseph M.
  • Wu, Liza C.

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