Rib-Sparing Internal Mammary Vessel Harvest for Microvascular Breast Reconstruction in 100 Consecutive Cases

• DOI: 10.1097/prs.0b013e3181a07249
• Publication Date: 2009-05-21T20:30:17Z
• Authors: Justin M. Sacks; David W. Chang
• Keywords: Mammary artery; Intercostal space; Intercostal arteries; Rectus abdominis muscle; Costal cartilage; Perforator flaps

Background: Using the internal mammary vessels as recipient in free-flap autologous breast reconstruction has become a common practice. However, these are typically accessed by removing costochondral segment. The purpose of this study was to describe authors' rib-sparing technique for accessing that is efficient and reliable limits chest wall morbidity. Methods: authors analyzed 100 consecutive free-tissue transfers which were using technique. data obtained from prospectively maintained database medical records. Results: Of reconstructions, 47 used deep inferior epigastric perforator flaps, 45 muscle-sparing transverse rectus abdominis myocutaneous six superficial artery two superior gluteal flaps. No rib cartilage removed 66, but segment 34 procedures optimize exposure facilitate anastomosis. After initial learning curve, however, approximately 90 percent cases without removal any cartilage. third intercostal space access two-thirds time, second one-third time. There no incidences complications or morbidity associated with approach vessel harvest. Conclusion: For most patients, an safe exposing vasculature microvascular while minimizing