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The Peritoneal Free Flap: An Anatomic Study

Winters, Henri A. H. M.D.; Bouman, Mark-Bram; Boom, Ferenc; Prosé, Poliacu L. Ph.D.

Plastic and Reconstructive Surgery: October 1997 - Volume 100 - Issue 5 - p 1168–1171
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In view of a possible clinical application of an isolated microvascular peritoneal flap, an anatomic study was performed in order to determine the peritoneal vascular territory of the deep inferior epigastric artery. For this, the deep inferior epigastric artery was injected unilaterally with Araldite in 30 embalmed cadavers and bilaterally with india ink in 15 fresh cadavers. In 70 percent of the embalmed cadavers, a constant pattern of three branches from the deep inferior epigastric artery could be identified. The peritoneal vascular supply is not derived solely from these three branches but also from multiple small branches sprouting directly from the main stem of the deep inferior epigastric artery and from segmental and muscular branches. Therefore, classification of peritoneal branches arising from the deep inferior epigastric artery seems to be of little clinical importance. In all cases, the india ink injected in the deep inferior epigastric artery colored a similar territory of the parietal peritoneum. Considering the magnitude of the peritoneal vascularization by the deep inferior epigastric artery, implementation of an isolated free or pedicled peritoneal flap seems to be possible.

Such a microvascular peritoneal flap vascularized by the deep inferior epigastric artery may be used, for example, for reconstruction of mucosal defects in the head and neck region. (Plast. Reconstr. Surg. 100: 1168, 1997.)

Amsterdam, The Netherlands

From the Department of Plastic, Reconstructive and Hand Surgery at the Academisch Ziekenhuis Vrije Universiteit and the Department of Anatomy at the Vrije Universiteit. Received for publication March 7, 1996; revised November 15, 1996.

Presented at the Autumn Symposium of the Dutch Society for Plastic and Reconstructive Surgery, in Eindhoven, The Netherlands, on October 14, 1995.

Henri A. H. Winters

Department of Plastic, Reconstructive and Hand Surgery

Academisch Ziekenhuis Vrije Universiteit

P.O. Box 7057

1007 MB Amsterdam

The Netherlands

©1997American Society of Plastic Surgeons