Tanya Emanuela Avram1, Maximilian Muntean2, Botond Janko3, Filip Ardelean4, Cosmin Pestean5, Radu Lacatus6, Ileana-Rodica Matei7, Alexandru Valentin Georgescu7. 1. University of Medicine and Pharmacy "IuliuHatieganu" Cluj-Napoca, Department of Plastic Surgery, Romania; Rehabilitation Clinical Hospital Cluj-Napoca, Department of Plastic Surgery, Romania. Electronic address: avram.tanya@umfcluj.ro. 2. Institute of Oncology Cluj-Napoca, Department of Plastic Surgery, Romania. 3. Rehabilitation Clinical Hospital Cluj-Napoca, Department of Plastic Surgery, Romania. 4. University of Medicine and Pharmacy "IuliuHatieganu" Cluj-Napoca, Department of Plastic Surgery, Romania; Rehabilitation Clinical Hospital Cluj-Napoca, Department of Plastic Surgery, Romania. Electronic address: flpardelean@yahoo.com. 5. University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, Department of Anesthesiology and Resuscitative Therapy, Romania. 6. University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, Department of Radiology and Radioprotection, Romania. 7. University of Medicine and Pharmacy "IuliuHatieganu" Cluj-Napoca, Department of Plastic Surgery, Romania; Rehabilitation Clinical Hospital Cluj-Napoca, Department of Plastic Surgery, Romania.
Abstract
INTRODUCTION: Free flaps require mastering microsurgical technique. In addition, breast reconstruction implies accuracy not only in flap survival, but also satisfying aesthetic outcome. Thus, such complex abilities can be acquired by creating experimental models for surgical training. MATERIALS AND METHODS: In accordance with relevant anatomy data found in literature, we chose a porcine model and performed a flap similar to the human deep inferior epigastric perforator (DIEP). Furthermore we developed a surgical protocol for a free flap transfer similar to a double-pedicle DIEP flap. The adipo-cutaneous flap was harvested as a free flap based on the superior abdominal vascularization and microsurgical anastomoses were performed to both the internal thoracic and thoracodorsal vessels. RESULTS: We were able to harvest a superior epigastric double-perforator free flap with increased similarity to the human DIEP flap. Microsurgical anastomoses were possible to both to the internal thoracic vessels and thoracodorsal vessels, which both proved to have optimal caliber for termino-terminal anastomosis. CONCLUSION: Although there are several differences when comparing a swine experimental model with human anatomy, our protocol enhances the possibilities for training in breast reconstruction.
INTRODUCTION: Free flaps require mastering microsurgical technique. In addition, breast reconstruction implies accuracy not only in flap survival, but also satisfying aesthetic outcome. Thus, such complex abilities can be acquired by creating experimental models for surgical training. MATERIALS AND METHODS: In accordance with relevant anatomy data found in literature, we chose a porcine model and performed a flap similar to the human deep inferior epigastric perforator (DIEP). Furthermore we developed a surgical protocol for a free flap transfer similar to a double-pedicle DIEP flap. The adipo-cutaneous flap was harvested as a free flap based on the superior abdominal vascularization and microsurgical anastomoses were performed to both the internal thoracic and thoracodorsal vessels. RESULTS: We were able to harvest a superior epigastric double-perforator free flap with increased similarity to the human DIEP flap. Microsurgical anastomoses were possible to both to the internal thoracic vessels and thoracodorsal vessels, which both proved to have optimal caliber for termino-terminal anastomosis. CONCLUSION: Although there are several differences when comparing a swine experimental model with human anatomy, our protocol enhances the possibilities for training in breast reconstruction.