<< Back to the abstract archive
Sensate DIEP-flaps for Breast Reconstruction: An Anatomic Feasibility Study
van Belle, Christopher MD
Morrison, Jillian MD
Nguyen, Binh MD
Rotatori, Max BS
Dale, Elizabeth MD
University of Cincinnati, OH
2017-02-14
Presenter: van Belle, Christopher
Affidavit:
Yes
Director Name: William John Kitzmiller
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Most modern flap-based breast reconstruction procedures performed today do not attempt to sensitize the reconstructed breast. Despite evidence that some sensation is nevertheless achieved postoperatively, it is unpredictable and substantially less than optimal, resulting in loss of protective sensation and resultant injuries. Few studies to date have characterized the feasibility of performing sensate DIEP flaps, and none have systematically linked abdominal neuroanatomy with that of the breast as encountered during a standard mastectomy dissection. In this study, two cadaver hemiabdomens and two cadaver chest walls were dissected and neuroanatomy carefully measured. Results: Each hemiabdomen contains an average of 9 sensory nerves, an average of 6 of which are deemed usable (diameter >1.0 mm). The course of these nerves is variable, and include intercostal nerves perforating lateral to the rectus muscle (average length 10.2 cm), and those perforating through lateral and medial rows of the rectus (average lengths 11.35 and 9.5 cm, respectively). Medial row perforating nerves were shortest in length but tended to travel with perforating vessels. The breasts derived sensation from the 2nd-4th intercostal nerves, which had average usable lengths of 11.5, 11.8, and 4.7 cm, respectively. Conclusion: Sensitization of DIEP flaps is feasible based on the number and length of sensory donor branches in the abdomen as well as availability and length of suitable recipient sensory branches in the chest wall.
