Midline epigastric scars can be associated with higher umbilical complications following DIEP flap harvest

Journal of Plastic, Reconstructive & Aesthetic Surgery(2022)

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Abstract
Results: A total of 243 patients met inclusion criteria, with 39 patients (16%) having prior surgery utilizing midline epigastric incisions. Twenty-one patients had umbilical complications. No significant difference in patient characteristics was found between patients with and with -out prior midline epigastric scars. Patients with a history of previous midline epigastric scars had a higher rate of umbilical complications (20.5% vs. 6.4%, p < 0.01). Bilateral medial row perforator-based DIEP flap harvest was also related to a higher rate of umbilical complications (18.4% vs. 6.2% p < 0.01). Conclusion: Previous midline epigastric scars are associated with higher rates of umbilical complications after DIEP flap harvest. Bilateral medial row perforator-based DIEP flap harvest exacerbates the rate of umbilical complications and should be avoided in patients with prior midline epigastric incision whenever possible. (c) 2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by El-sevier Ltd. All rights reserved.
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Key words
Diep inferior epigastric perforator,DIEP flap,DIEP flap breast reconstruction,Breast reconstruction,Umbilicus,Umbilical necrosis
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