PR14 IMPROVING DISSECTION OF PERFORATORY ARTERIES

Perforator flaps such as the deep inferior epigastric artery (DIEA) perforator flap is used increasingly for breast reconstruction. This is often preferred to traditional transverse rectus abdominis musculocutaneous (TRAM) flaps where sparing of muscle significantly reduces the risk of abdominal wall weakness. Perforators however are often small (diameter of less than 1 mm) and travel substantial longitudinal and transverse distances within the rectus abdominus muscle. Some surgeons therefore, may find the DIEA perforator flap technically more difficult to dissect than the traditional TRAM flap. Pre-operative CT angiography (CTA) plays an integral part in mapping the size and location of these perforators. We describe a simple intra-operative technique, commonly used in plastic and ophthalmic surgery, which is invaluable in assisting the surgeon in the dissection of these perforators. This technique has been performed successfully on over 12 patients in the last 2 years.