Strategy and technical points of harvesting different forms of free rectus abdominis muscle flap combined with free superficial inferior epigastric artery perforator flap for unilateral breast reconstruction
10.3760/cma.j.cn114657-20240422-00058
- VernacularTitle:制备不同形式游离腹直肌皮瓣联合游离腹壁浅动脉穿支皮瓣再造单侧乳房的策略和技术要点
- Author:
Ruqi GUO
1
;
Tianyi ZHANG
;
Dajiang SONG
;
Zhiyuan WANG
;
Xu LIU
;
Zan LI
Author Information
1. 长治医学院附属长治市人民医院乳腺外科，长治 046000
- Publication Type:Journal Article
- Keywords:
Breast neoplasms;
Rectus abdominis flap;
Superficial inferior epigastric artery perforator flap;
Breast reconstruction
- From:
Chinese Journal of Medical Aesthetics and Cosmetology
2025;31(2):93-98
- CountryChina
- Language:Chinese
-
Abstract:
The free inferior epigastric artery perforator flap is currently a highly regarded autologous breast reconstruction technique. However, in clinical practice, the anatomical characteristics of the lower abdominal vasculature and surrounding tissue structures do not always permit ideal perforator flap harvesting. In many cases, it becomes necessary to preserve a larger rectus abdominis muscle cuff to ensure reliable blood supply to the flap through the perforating vessels. Compared with various forms of rectus abdominis myocutaneous flaps that all require incision of the anterior sheath and intramuscular vascular pedicle dissection, the superficial inferior epigastric artery (SIEA) perforator flap significantly reduces donor-site morbidity. Nevertheless, the anatomical variability of the superficial inferior epigastric vessels increases surgical uncertainty. Based on clinical observations, this study establishes a comprehensive clinical strategy algorithm. Primarily focusing on different configurations of free rectus abdominis flaps, it incorporates additional preparation of free SIEA perforator flaps when anatomical conditions permit. The objectives are to ensure reliable perfusion of the lower abdominal flap while minimizing donor-site damage and reducing surgical complexity.
