Work

“The Three Gorges” flap based on three tributaries—the bilateral deep inferior epigastric, superficial circumflex and external pudendal systems

Year: 2025

Type: article

Abstract: This study aims to identify a novel mega-flap from the abdominal region. The flap is an extension of the bipedicled DIEP to incorporate the bilateral superficial circumflex iliac perforator (SCIP) and external pudendal arterial systems. These arise from the common femoral artery, hence termed "The Three Gorges" flap. We utilized a novel indocyanine green fluorescence angiography method to evaluate the perfusion of this flap solely via the bilateral DIEP pedicles. Anatomical dissection of three cadavers was performed to map the perfusion zone of the flap via bilateral DIEP pedicles. Indocyanine green fluorescence angiography was employed to capture the perfusion in real time. The SCIP and superficial external pudendal systems can be perfused by the DIEP pedicle. A novel mega-flap based on three tributaries from bilateral DIEP, SCIP, and superficial external pudendal arterial systems can be supplied by bilateral DIEP pedicles.

Source: Journal of Surgical Case Reports

DOI: 10.1093/jscr/rjaf408

Authors: Nadia Hui Shan Sim, Allen Wei-Jiat Wong

Institution: Sengkang General Hospital

Language: English

Topic: Reconstructive Surgery and Microvascular Techniques

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,000