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Proceedings Article

In-vivo quantitative evaluation of perfusion zones and perfusion gradient in the deep inferior epigastric artery perforator flap

[+] Author Affiliations
Michel Saint-Cyr

Mayo Clinic (United States)

Chrisovalantis Lakhiani, Angela Cheng, Michael Mangum, Sumeet Teotia, Edward H. Livingston, Karel J. Zuzak

The Univ. of Texas Southwestern Medical Ctr. at Dallas (United States)

Jinyang Liang

Digital Light Innovations (United States)

Proc. SPIE 8618, Emerging Digital Micromirror Device Based Systems and Applications V, 861806 (March 8, 2013); doi:10.1117/12.2004972
Text Size: A A A
From Conference Volume 8618

  • Emerging Digital Micromirror Device Based Systems and Applications V
  • Michael R. Douglass; Patrick I. Oden
  • San Francisco, California, USA | February 02, 2013

abstract

The selection of well-vascularized tissue during DIEP flap harvest remains controversial. While several studies have elucidated cross-midline perfusion, further characterization of perfusion to the ipsilateral hemiabdomen is necessary for minimizing rates of fat necrosis or partial fat necrosis in bilateral DIEP flaps. Eighteen patients (29 flaps) underwent DIEP flap harvest using a prospectively designed protocol. Perforators were marked and imaged with a novel system for quantitatively measuring tissue oxygenation, the Digital Light Hyperspectral Imager. Images were then analyzed to determine if perforator selection influenced ipsilateral flap perfusion. Flaps based on a single lateral row perforator (SLRP) were found to have a higher level of hemoglobin oxygenation in Zone I (mean %HbO2 = 76.1) compared to single medial row perforator (SMRP) flaps (%HbO2 = 71.6). Perfusion of Zone III relative to Zone I was similar between SLRP and SMRP flaps (97.4% vs. 97.9%, respectively). These differences were not statistically significant (p>0.05). Perfusion to the lateral edge of the flap was slightly greater for SLRP flaps compared SMRP flaps (92.1% vs. 89.5%, respectively). SMRP flaps had superior perfusion travelling inferiorly compared to SLRP flaps (88.8% vs. 83.9%, respectively). Overall, it was observed that flaps were better perfused in the lateral direction than inferiorly. Significant differences in perfusion gradients directed inferiorly or laterally were observed, and perforator selection influenced perfusion in the most distal or inferior aspects of the flap. This suggests broader clinical implications for flap design that merit further investigation. © (2013) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only.
Citation

Michel Saint-Cyr ; Chrisovalantis Lakhiani ; Angela Cheng ; Michael Mangum ; Jinyang Liang, et al.
" In-vivo quantitative evaluation of perfusion zones and perfusion gradient in the deep inferior epigastric artery perforator flap ", Proc. SPIE 8618, Emerging Digital Micromirror Device Based Systems and Applications V, 861806 (March 8, 2013); doi:10.1117/12.2004972; http://dx.doi.org/10.1117/12.2004972


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