Superficial inferior epigastric artery flap: Vascular pattern and territory across the midline
4
Issued Date
2023-01-01
Resource Type
ISSN
0743684X
eISSN
10988947
Scopus ID
2-s2.0-85175855004
Pubmed ID
37884058
Journal Title
Journal of Reconstructive Microsurgery
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Reconstructive Microsurgery (2023)
Suggested Citation
Lohasammakul S., Tonaree W., Suppasilp C., Numwong T., Ratanalekha R., Han H.H. Superficial inferior epigastric artery flap: Vascular pattern and territory across the midline. Journal of Reconstructive Microsurgery (2023). doi:10.1055/a-2199-3960 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/91031
Title
Superficial inferior epigastric artery flap: Vascular pattern and territory across the midline
Other Contributor(s)
Abstract
Background: Superficial inferior epigastric artery (SIEA) flap offers a significant advantage of lower donor site morbidity over other abdominal-based flaps for breast reconstruction. However, the inconsistent anatomy and territory across the midline remains a major issue. This study aimed to investigate the SIEA and determine its pattern and territory across the midline. Methods: Twenty cadavers were studied. Ipsilateral dye was injected to the dominant SIEA. Dissection was performed to evaluate the SIEA origin, artery and vein pattern, vessel diameter, and dye diffusion territory. Results: Overall, three SIEA patterns were identified: bilateral presence (45%), ipsilateral presence (30%), and bilateral absence (25%). The territory depended on the vessel course and dominant SIEA diameter, not on its common origin from the femoral artery, at the pubic tubercle level. Regarding the midline territory (pubic tubercle level to umbilicus), SIEA with a diameter of ≥1.4 mm on either side (type 1a) supplied at least half the distance, whereas SIEA with a diameter of <1 mm (type 1b) was limited to the suprapubic area. Conclusions: Designing a SIEA flap island across the midline is feasible when contralateral SIEA is present to augment the contralateral territory (e.g., type 1a SIEA) or in SIEA with a common/superficial external pudendal artery origin. Preoperative imaging studies are important for confirming the SIEA system. When the diameter at the origin of the SIEA flap is larger than 1.4 mm, the blood supply to the ipsilateral and contralateral sides is sufficient to enable safe flap elevation.