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Updated: Sep 17, 2025

A Model of Free Tissue Transfer: The Rat Epigastric Free Flap
Published on: January 15, 2017
"The Three Gorges" flap based on three tributaries-the bilateral deep inferior epigastric, superficial circumflex and
Nadia Hui Shan Sim1, Allen Wei-Jiat Wong1
1Plastic, Reconstructive & Aesthetic Surgery Service, Sengkang General Hospital, 110 Sengkang E Way, Singapore 544886, Singapore.
Abstract:
This study aims to identify a novel mega-flap from the abdominal region. The flap is an extension of the bipedicled DIEP to incorporate the bilateral superficial circumflex iliac perforator (SCIP) and external pudendal arterial systems. These arise from the common femoral artery, hence termed "The Three Gorges" flap. We utilized a novel indocyanine green fluorescence angiography method to evaluate the perfusion of this flap solely via the bilateral DIEP pedicles. Anatomical dissection of three cadavers was performed to map the perfusion zone of the flap via bilateral DIEP pedicles. Indocyanine green fluorescence angiography was employed to capture the perfusion in real time. The SCIP and superficial external pudendal systems can be perfused by the DIEP pedicle. A novel mega-flap based on three tributaries from bilateral DIEP, SCIP, and superficial external pudendal arterial systems can be supplied by bilateral DIEP pedicles.
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