Abdominal Donor Site Morbidity Associated with the Bilateral
Deep Inferior Epigastric Perforator Flap for Breast Reconstruction.
Robert Allen, MD, and
Brenda Mahon-Deri, MD.
Department of Surgery, Division of Plastic Surgery, Louisiana
State University Medical Center, New Orleans.
Since 1992, the LSU Division of Plastic Surgery has done
30 deep inferior epigastric perforator (DIEP) flaps for bilateral
breast reconstruction. A majority of these procedures were
done simultaneously. The staged reconstructions were usually
separated by a 1-week period. The donor site morbidity associated
with the TRAM flap has been well documented, including bulging
and hernias of the abdominal wall.
These problems are exaggerated with bilateral TRAMs. With
perforator flaps, there is no anterior rectus sheath or muscle
sacrificed, therefore one would expect decreased donor site
morbidity. Our series reports no abdominal hernias or bulges
postoperatively. Preoperative and postoperative rectus muscle
studies are being done. Patient questionnaires on donor site
morbidity are being reviewed. We believe that our DIEP flap
offers significant improvements in donor site morbidity compared
with the traditional TRAM.
Southern Medical Journal Volume
89, No. 10, October 1996
