Mah, Eldon, Rozen, Warren M., Ashton, Mark W., and Flood, Stephen (2009) Deep superior epigastric artery perforators: anatomical study and clinical application in sternal reconstruction. Plastic and Reconstructive Surgery, 123 (6). pp. 1719-1723.

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Abstract

[Extract] Perforators of the deep superior epigastric artery traverse the rectus abdominis muscle to supply the upper abdominal wall integument. These perforators have been used in the past as the basis for vertical and transverse rectus abdominis myocutaneous flaps,1–4 and for thoracoepigastric fasciocutaneous flaps. Although flaps based on deep superior epigastric artery perforators have been described in a range of clinical settings, we would like to share our experience in applying this flap for sternal reconstruction. Sternal wound dehiscence is a challenging reconstructive problem, with reconstructive options including rectus abdominis muscle, pectoralis major muscle, and omentum, but situations exist where these are not feasible and other options are sought. The current study contributes to this list of options by reporting our experience with the deep superior epigastric artery perforator/thoracoepigastric flap for difficult sternal reconstructions. In developing this flap, we undertook an anatomical study with clinical computed tomographic angiography studies to improve flap design. Although previous cadaveric studies have delineated some of this anatomy, in vivo clinical studies of this anatomy have been sparse.

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