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A female asked:

What is a pedicled flap for breast reconstruction? i've been researching my options for breast reconstruction surgery and i'm confused by the different kinds of flaps the surgeon can use. i'm especially unsure what is a pedicled flap, and how is it differ

4 doctor answers8 doctors weighed in
Dr. Karen Vaniver
Plastic Surgery 37 years experience
A : A pedicled flap is a flap that has a blood supply connected to the flap from its original site. Examples include the pedicled tram flap, which takes the rectus abdominus muscle (or sit-up muscle) with it, containing the superior deep epigastric artery, and the latissimus dorsi myocutanous flap, which carries the thoracodorsal artery along with the latissimus muscle. The tram flap is used to create a breast out of abdominal skin and fat, while the latissimus flap is used to provide muscle and skin coverage over an expander or implant. This is espiecially useful in a patient who has had radiation. A free flap is a flap that has its original blood supply divided. The artery (and vein) to the flap is then connected to a new blood supply under the microscope. The new blood supply is usually the internal mammary artery, which runs lateral to the sternum or breast bone. The flap vessel used is the deep inferior epigastric pedicle (diep flap). This bloode vessel comes from below the abdomen and doesn't run through the sit-up muscle. The purpose of a free flap in breast reconstruction is to improve circulation, and to prevent the side effects resulting from removing the sit-up muscle from the abdominal wall, which can lead to hernia or bulging. The free flap is a complicated procedure that should be done by a surgeon who has ecperience with this technique.
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Dr. Leonard Grossman
Plastic Surgery 38 years experience
In : In the pedicled flap the blood vessel is still attached to its original supply. In the free flap, the blood vessel gets attached surgically to a new vessel for the blood supply. Good luck from nyc. For more info visit www.Drgrossman.Com.
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Dr. Otto Placik
Surgery - Plastics 36 years experience
A : A flap refers to tissues that are isolated by surgery. When no discreet blood vessel supports the tissue, we call it a random flap. When the flap has an identifiable blood supply we can rotate the flap based on a "stalk" of tissue containing the blood vessels which continue to nourish the tissues when moved to a recipient location than the donor site. When the stalk is attached and the tissues are transferred to a new place we call it a "pedicled" flap. When the stalk is severed and the tissues are thereby "freed" from the donor site and re-attached to the recipient site by sewing the blood vessels together, we call it a "free flap" common pedicled flaps from the breast come from the abdomen (pedicled tram) or back (latissimus dorsi) but there are many other examples.
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Dr. Robert Whitfield
Specializes in Plastic Surgery
Breast Cancer: All the discussion around pedicles refers to the artery and vein that provide blood flow to and from a particular area of tissue or organ for that matter. Plastic surgeons with experience in surgery using a microscope can cut the artery and vein of a vascular pedicle and move the tissue to a new position any. Where on the body where there is a suitable artery and being to reconnect the tissue.
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Last updated Oct 4, 2016


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