Abdominal perforator exchange (APEX) technique in delayed breast reconstruction with deep inferior epigastric artery perforator (DIEAP) flap

Melnikov D.V.; Abdeeva E.I.; Ivanov S.I.; Gombolevskiy V.A.

doi:https://doi.org/10.17116/plast.hirurgia202502152

Melnikov D.V.

Sechenov First Moscow State Medical University;
Institute of Plastic Surgery and Cosmetology

ORCID: 0000-0002-7960-0951

Abdeeva E.I.

Sechenov First Moscow State Medical University

ORCID: 0000-0003-0283-5370

Ivanov S.I.

Sechenov First Moscow State Medical University;
Institute of Plastic Surgery and Cosmetology

ORCID: 0000-0002-8365-360X

Gombolevskiy V.A.

Sechenov First Moscow State Medical University;
Artificial Intelligence Research Institute

ORCID: 0000-0003-1816-1315

Abdominal perforator exchange (APEX) technique in delayed breast reconstruction with deep inferior epigastric artery perforator (DIEAP) flap

Authors:

Melnikov D.V., Abdeeva E.I., Ivanov S.I., Gombolevskiy V.A.

More about the authors

Journal: Plastic Surgery and Aesthetic Medicine. 2025;(2): 52‑60

DOI: 10.17116/plast.hirurgia202502152

Read: 1362 times

To cite this article:

Melnikov DV, Abdeeva EI, Ivanov SI, Gombolevskiy VA. Abdominal perforator exchange (APEX) technique in delayed breast reconstruction with deep inferior epigastric artery perforator (DIEAP) flap. Plastic Surgery and Aesthetic Medicine. 2025;(2):52‑60. (In Russ., In Engl.)
https://doi.org/10.17116/plast.hirurgia202502152

Подписка 2026 Пластическая хирургия и эстетическая медицина (Plastic Surgery and Aesthetic Medicine)

Использование инфографики авторами научных работ

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OBJECTIVE

To reduce donor site morbidity and optimize the concept of perforator vessel choosing in delayed breast reconstruction with deep inferior epigastric artery perforator (DIEAP) flap.

MATERIAL AND METHODS

We retrospectively analyzed abdominal perforator exchange (APEX) technique for delayed breast reconstruction with DIEAP flap in patients who underwent surgery between April 2020 and October 2024. All patients underwent preoperative magnetic resonance angiography of the donor area. Patients were divided into two groups: the study group included patients who underwent breast reconstruction using the abdominal perforator exchange (APEX) technique, while the control group consisted of patients who underwent reconstruction with the standard DIEP flap approach. Statistical analysis was performed using the program StatTech v. 4.7.2 (StatTech LLC, Russia).

RESULTS

Three different types of perforator bifurcation were identified among patients in the APEX group, with bifurcation type “A” being the most common. The mean operative time and pedicle dissection time were significantly longer in the APEX group. A statistically significant difference in fascial incision length was also observed. Satisfaction with functional status of anterior abdominal wall was higher in the APEX group. There were no significant differences in satisfaction with donor site appearance.

Keywords:

breast reconstruction

DIEAP flap

perforator flaps

perforator vessel selection

donor site morbidity

abdominal perforator exchange (APEX)

Authors:

Melnikov D.V.

Sechenov First Moscow State Medical University;
Institute of Plastic Surgery and Cosmetology

ORCID: 0000-0002-7960-0951

Abdeeva E.I.

Sechenov First Moscow State Medical University

ORCID: 0000-0003-0283-5370

Ivanov S.I.

Sechenov First Moscow State Medical University;
Institute of Plastic Surgery and Cosmetology

ORCID: 0000-0002-8365-360X

Gombolevskiy V.A.

Sechenov First Moscow State Medical University;
Artificial Intelligence Research Institute

ORCID: 0000-0003-1816-1315

Received:

10.02.2025

Accepted:

08.03.2025

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References:

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