CT-guided deep inferior epigastric perforator (DIEP) flap localization -- better for the patient, the surgeon, and the hospital

Clin Radiol. 2013 Feb;68(2):131-8. doi: 10.1016/j.crad.2012.06.105. Epub 2012 Aug 11.

Abstract

Aims: To define the clinical benefits to the patient of preoperative imaging planning for deep inferior epigastric perforator (DIEP) flap reconstruction.

Materials and methods: Since 2009 computed tomography angiography (CTA) has been provided for the preoperative planning of DIEP flap breast reconstruction in the largest plastic surgery unit in southeast England. In a retrospective, cohort-control study the outcomes of 100 consecutive patients who underwent preoperative CTA planning were compared with a closely-matched control group who underwent ultrasound planning only. The cohorts were evaluated for operative duration, mean operative blood loss and transfusion requirement, morbidity and flap or donor-site complications.

Results: There were statistically significant improvements in mean operative duration (p < 0.05), intra-operative blood loss (p < 0.05), shorter mean inpatient stay (p < 0.05) for the CTA planning versus the ultrasound planning of DIEP flap reconstruction.

Conclusion: Statistically significant benefits were demonstrated in key aspects of the surgical procedure following CTA-guided planning. The implications of these benefits are profound in terms of pure healthcare cost benefits.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Angiography / methods
  • Blood Loss, Surgical
  • Breast Neoplasms / surgery
  • Case-Control Studies
  • Epigastric Arteries*
  • Female
  • Follow-Up Studies
  • Graft Rejection
  • Graft Survival
  • Humans
  • Length of Stay
  • Mammaplasty / methods*
  • Mastectomy / methods
  • Middle Aged
  • Perforator Flap / blood supply*
  • Preoperative Care / methods
  • Rectus Abdominis / blood supply
  • Rectus Abdominis / transplantation
  • Retrospective Studies
  • Risk Assessment
  • Tomography, X-Ray Computed / methods*
  • Treatment Outcome
  • Ultrasonography, Mammary / methods*
  • United Kingdom