Anatomical features of perforator blood vessels in the deep inferior epigastric perforator flap

The anatomical basis of the blood supply to the deep inferior epigastric pe rforator (DIEP) flap and the circulation of the cutaneous territory zone IV have been studied in 30 anatomical dissections on fresh cadavers. The pedi cle length? diameter and the number and distribution of the major perforato r vessels were recorded, The cutaneous territories supplied by the perforat or vessels were studied by injecting blue dye in the pedicle of ten specime ns. In addition, intravital blue dye studies were performed by injecting th e largest perforating vessel of five patients at abdominoplasty. The result ing cutaneous staining was recorded. The deep inferior epigastric artery wa s present in all cadaver dissections with an average length of 10.3 cm (ran ge 9.0-13 cm) and an average diameter of 3.6 mm (range 2.8-5.0 mm). There w ere consistently one or two major perforator vessels for each pedicle, loca ted within a radius of 8 cm below the umbilicus. The results of the injecti on study revealed cutaneous staining of zones I-III. Zone IV was stained we akly or not at all. The same findings were obtained in the clinical cases o f abdominoplasty. Zone IV must be critically assessed in clinical cases of the DIEP flap. (C) 2000 The British Association of Plastic Surgeons.