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Updated: Jun 24, 2026
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An Experimental Human DIEP Flap Model to Investigate Preservation Strategies for Vascularized Composite Allografts and Free Flaps
Published on: December 5, 2025
The "limited rectus sheath incisions" technique for DIEP flaps using preoperative CT angiography
1Jack Brockhoff Reconstructive Plastic Surgery Research Unit, Department of Anatomy and Cell Biology, The University of Melbourne, Parkville, VIC, Australia. warrenrozen@hotmail.com
Microsurgery
|March 20, 2009
Summary
This study introduces a novel "limited rectus sheath incisions" technique to minimize abdominal donor site damage during deep inferior epigastric artery perforator (DIEP) flap harvest for breast reconstruction. This method may reduce rectus sheath injury and improve patient outcomes.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Microsurgery
Background:
- Abdominal wall donor sites are popular for autologous breast reconstruction due to low morbidity.
- Muscle-sparing techniques like the deep inferior epigastric artery perforator (DIEP) flap have improved outcomes.
- Modifications to rectus sheath closure, including endoscopic techniques and mesh, further enhance donor site results.
Purpose of the Study:
- To introduce and describe a novel technique for minimizing donor site damage during DIEP flap harvest.
- To present the "limited rectus sheath incisions" technique as a method to potentially reduce morbidity.
- To identify patient selection criteria, aided by preoperative computed tomography angiography (CTA), for this technique.
Main Methods:
- Description of the "limited rectus sheath incisions" technique for DIEP flap harvest.
- Utilizing preoperative computed tomography angiography (CTA) to identify suitable candidates.
- Performing limited, muscle-splitting incisions in the rectus sheath to access perforators and the pedicle.
Main Results:
- The technique involves specific incisions to access periumbilical perforators and the pedicle near its origin.
- This approach may reduce damage to the anterior rectus sheath compared to traditional methods.
- Potentially contributes to improved donor site morbidity in select patients.
Conclusions:
- The "limited rectus sheath incisions" technique offers a novel approach to minimize donor site damage in DIEP flap breast reconstruction.
- Preoperative CTA is valuable for patient selection in cases with extended DIEA segments lacking musculocutaneous perforators.
- This technique has the potential to further reduce donor site morbidity, enhancing reconstructive surgery outcomes.
