OBJECTIVETo investigate the anatomic characteristics of the perforator neurovascular bundles in the anterior abdominal wall for the anatomical basis of the sensate deep inferior epigastric perforator (DIEP) flap.

METHODSAbdominal wall dissection was performed on 9 embalmed female cadavers (18 sides).

RESULTSMost of the deep inferior epigastric perforators emerged at the anterior sheath of the rectus. There were averaged 17.5 perforators on each side, with the diameter equal to or larger than 0.5 mm in 7.8 perforators. The number of skin perforators was the greatest in the supero-medial area. 56.2 percent of vascular perforators traveled with the sensory branches while 80.9 percent of larger perforators (> or = 0.5 mm in diameter) run with the sensory branches.

CONCLUSIONSThe lateral perforator neurovascular bundle was the first choice in the design of the sensate DIEP flap.

Abdominal Wall ; anatomy & histology ; Cadaver ; Female ; Humans ; Intercostal Nerves ; anatomy & histology ; Surgical Flaps

We performed sympathetic nerve reconstruction using intercostal nerve in patients with severe compensatory hyperhidrosis after sympathetic surgery for primary hyperhidrosis, and analyzed the surgical results. From February 2004 to August 2007, sympathetic nerve reconstruction using intercostal nerve was performed in 19 patients. The subjected patients presented severe compensatory hyperhidrosis after thoracoscopic sympathetic surgery for primary hyperhidrosis. Reconstruction of sympathetic nerve was performed by thoracoscopic surgery except in 1 patient with severe pleural adhesion. The median interval between the initial sympathetic surgery and sympathetic nerve reconstruction was 47.2 (range: 3.5-110.7) months. Compensatory sweating after the reconstruction surgery improved in 9 patients, and 3 out of them had markedly improved symptoms. Sympathetic nerve reconstruction using intercostal nerve may be one of the useful surgical options for severe compensatory hyperhidrosis following sympathetic surgery for primary hyperhidrosis.
Adult ; Female ; Humans ; Hyperhidrosis/*surgery ; Intercostal Nerves/anatomy & histology/surgery ; Male ; Middle Aged ; Patient Satisfaction ; Quality of Life ; Questionnaires ; Reconstructive Surgical Procedures/*methods ; Sympathetic Nervous System/anatomy & histology/*surgery ; Treatment Outcome ; Young Adult