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CC BY-NC 4.0 · Arch Plast Surg 2014; 41(02): 171-173
DOI: 10.5999/aps.2014.41.2.171
Idea and Innovation

A Preoperative Marking Template for Deep Inferior Epigastric Artery Perforator Flap Perforators in Breast Reconstruction

Benjamin H Miranda
Royal Free London NHS Foundation Trust, London, UK
,
Matthew Pywell
Royal Free London NHS Foundation Trust, London, UK
,
David Floyd
Royal Free London NHS Foundation Trust, London, UK
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Preoperative perforator marking for deep inferior epigastric artery perforator flaps is vital to the success of the procedure in breast reconstruction. Advances in imaging have facilitated accurate identification and preselection of potentially useful perforators. However, the reported imaging accuracy may be lost when preoperatively marking the patient, due to 'mapping errors', as this relies on the use of 2 reported vectors from a landmark such as the umbilicus. Observation errors have been encountered where inaccurate perforator vector measurements have been reported in relation to the umbilicus. Transcription errors have been noted where confusing and wordy reports have been typed or where incorrect units have been given (millimetres vs. centimetres). Interpretation errors have also occurred when using the report for preoperative marking. Furthermore, the marking process may be unnecessarily time-consuming. We describe a bespoke template, created using an individual computed tomography angiography image, that increases the efficiency and accuracy of preoperative marking. The template is created to scale, is individually tailored to the patient, and is particularly useful in cases where multiple potential suitable perforators exist.

Keywords

Free tissue flaps - Perforator flaps - Mastectomy - Breast neoplasms - Tomography, X-ray computed


Publication History

Received: 21 November 2013

Accepted: 18 December 2013

Article published online:
02 May 2022

© 2014. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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