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Three-Dimensional Visualization for Extended Deep Inferior Epigastric Perforator Flaps
HuaiRui Cui, MaoCao Ding1, YiHua Mao1
1Department of Anatomy, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, China.
Annals of Plastic Surgery
|May 21, 2020
Summary
This study provides a digital anatomical basis for extended deep inferior epigastric perforator (DIEP) flaps, identifying key perforator locations and enabling precise flap design using 3D reconstruction. This enhances clinical application of DIEP flaps.
Area of Science:
- Anatomical studies
- Surgical anatomy
- Medical imaging
Background:
- Deep inferior epigastric perforator (DIEP) flaps are crucial in reconstructive surgery.
- Acquiring extended DIEP flaps requires precise anatomical understanding.
- Digital anatomical data can enhance surgical planning and outcomes.
Purpose of the Study:
- To establish an applied and digital anatomical foundation for harvesting extended DIEP flaps.
- To utilize 3D imaging techniques for detailed visualization of DIEP perforators.
- To facilitate improved clinical application of DIEP flap procedures.
Main Methods:
- Dissection of formalin-fixed specimens with latex injection.
- Arteriography on cadavers followed by spiral computed tomography (CT) scanning.
- 3D reconstruction of DIEP perforators using Mimics software with volume rendering (VR) and dynamic reconstruction (DR).
Main Results:
- DIEP arteries' medial row perforators are in the medial 1/3, lateral row in the lateral 1/3 of the rectus abdominis muscle.
- Perforators are concentrated within 8.0 cm, notably 4.0 cm, around the umbilicus, with diameters ≥0.8 mm and associated nerves.
- VR and DR methods enabled intuitive visualization and free combination of adjacent perforators for extended flap design.
Conclusions:
- Large extended DIEP flaps with nerves can be harvested based on this anatomical data.
- Selecting perforators near the umbilicus is recommended for DIEP flap design.
- Mimics software's VR and DR methods provide a convenient and intuitive 3D model for extended DIEP flaps.
