Deep inferior epigastric perforators do not correlate between sides of the body: the role for preoperative imaging.

The deep inferior epigastric artery (DIEA) perforator (DIEP) flap has been widely described as a safe flap with reliable vascular anatomy. One of its limitations is potentially lengthy operating times during flap harvest, and many techniques have been reported to reduce operating times. One such technique is the preoperative selection of perforators with imaging, which has been shown to substantially reduce operating times. In the past, a technique utilised for perforator selection was to raise one hemi-abdominal wall purely for perforator identification, and to use the location of perforators as a predictor for the contralateral hemiabdominal wall. However, anatomical studies have highlighted substantial variability between DIEA perforators both within and between individuals, and the anatomical basis for such a technique has not been demonstrated in any anatomical studies. The current study thus sought to compare the abdominal wall perforators of each side of the body to confirm whether such a correlation between sides exists.