This article is more than 5 years old. Information may no longer be current.

DIEP flap with tissue expander, alloderm sling safe in women with insufficient abdominal tissue

Researchers successfully utilized deep inferior epigastric perforator flap reconstruction in combination with tissue expander/implant using an alloderm sling technique in patients lacking sufficient abdominal tissue, or in those with existing breast asymmetries.

Between January 2009 and December 2012, the researchers retrospectively reviewed data from five patients who underwent simultaneous deep inferior epigastric perforator (DIEP) flap and expander/implant placement as a result of inadequate abdominal tissue. Average patient age was 50 years, and all patients included in the study had early disease, few comorbidities and were not smokers. Length of follow-up ranged from 6 months to 18 months.

According to the researchers, one of the patients had prior bilateral tissue expander (TE) placement with postoperative radiation and subsequent infections, which led to significant bilateral deformities and the need for a second reconstruction.

Four of the five patients who underwent immediate DIEP flap/TE reconstruction had bilateral procedures, whereas one patient had a stacked DIEP flap with implant placement for a unilateral defect. Overall, no reoperations, venous congestion episodes, hematomas, partial or total flap losses, seromas, infections or expander/implant leaks were reported. Additionally, the researchers found no occurrences of expander/implant intrusion.

The average final expander size was 325 mL, ranging from 200 mL to 400 mL.

All patients described being "very satisfied" with their reconstructive results, according to the researchers.

The researchers concluded that this technique may assist surgeons in preventing any inadvertent injury to the pedicle when performing simultaneous DIEP flap/expander reconstruction and using the inferior mesenteric artery/inferior mesenteric vein as the recipient vessels. - by Abigail Sutton

Disclosure: The researchers report no relevant financial disclosures.