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Perforator selection may be useful in reducing perfusion-related flap complications

Adding a lateral row perforator to a dominant medial row perforator may reduce fat necrosis in flap breast reconstruction, according to recent findings.

The aim of the retrospective review was to assess perfusion-related complications in 728 hemiflaps from women who underwent bilateral deep inferior epigastric perforator (DIEP) flap breast reconstruction. The researchers grouped the hemiflaps into three cohorts: there were 263 based on the lateral row only, 225 based on the medial row only, and 240 based on the medial plus lateral row.

According to the researchers, the three arms were balanced in terms of perforator number and flap weight. Flaps based on lateral row perforators had a fat necrosis rate of 8.2%, compared with 24.5% in flaps based solely on the medial row (P < .001). Fat necrosis was similar in flaps based only on the lateral row (8.2%) and flaps based on the medial and lateral row (11.6%; P = .203).

Other findings indicated that in the same row, an increase in the number of perforators led to a decrease in the incidence of fat necrosis. – by Rob Volansky

Disclosure: The researchers report no relevant financial disclosures.