High-volume hydrodissection: Assessment of deep inferior epigastric perforator flap perfusion using laser doppler

Paolo Maria Fanzio, Ming Huei Cheng, Ivan Samcam, Yu Te Lin, Vijay Gorantla, Bernard T. Lee, Dhruv Singhal*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

2 Scopus citations


High-volume hydrodissection of intramuscular perforators of deep inferior epigastric perforator (DIEP) flaps in Sprague-Dawley rats has previously demonstrated a significant reduction in dissection time while simultaneously increasing the safety of dissection. However, increasing volumes of fluid injected into the closed rectus compartment may have adverse consequences on perfusion to the overlying flap. A prospective experimental animal study was performed to define a safe upper limit of volume injection for high-volume hydrodissection. Eight Sprague-Dawley rats underwent bilateral "DIEP" f lap dissections with varying volumes of f luid (1, 3, 6, and 9 mL) injected into the study side. The primary outcome measurement was overlying tissue perfusion, measured using laser Doppler imaging, at 6 separate time points during the flap harvest.Although no significant difference in perfusion was noted between study and control sides despite increasing volumes of injection, a trend toward significant altered perfusion was noted immediately after injection in the 9-mL study group. Six milliliters is defined as the safe upper limit volume of injection into the closed rectus compartment without significantly altering overlying f lap perfusion in our Sprague-Dawley rats. Using volumetric analysis, these data translate to 425 mL as the safe upper limit for high-volume hydrodissection for a single average sized human rectus sheath during DIEP flap harvesting. The mechanical and potentially pharmacologic implications of these data in humans remain to be seen.

Original languageEnglish
Pages (from-to)652-656
Number of pages5
JournalAnnals of Plastic Surgery
Issue number6
StatePublished - 2015

Bibliographical note

Publisher Copyright:
© 2015 Wolters Kluwer Health, Inc. All rights reserved.


  • Hydrodissection
  • Intramuscular perforator
  • Laser Doppler imaging
  • Perforator flap


Dive into the research topics of 'High-volume hydrodissection: Assessment of deep inferior epigastric perforator flap perfusion using laser doppler'. Together they form a unique fingerprint.

Cite this