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Page 4 of 15 Sarrami et al. Plast Aesthet Res 2024;11:13 https://dx.doi.org/10.20517/2347-9264.2024.06
Figure 1. Preoperative markings of DIEP flap with inguinal lymph node harvest. Femoral vessels are drawn in red. The arrow depicts the
groin crease with the lymph nodes available for harvest above (red) and the lymph nodes draining the leg below (green). DIEP: deep
inferior epigastric perforator.
Figure 2. Lymphatic mapping of DIEP flap with inguinal lymph nodes using ICG. The fluorescent dye shows lymphatic drainage
pathways into the inguinal lymph nodes. ICG: indocyanine green; DIEP: deep inferior epigastric perforator.
Figure 3. (Right) Inguinal lymph node harvest attached to DIEP flap; (Left) Preserved superficial circumflex iliac perforator for
anastomosis into the axilla. DIEP: deep inferior epigastric perforator.
[16]
10% in the arm 90 days postop . Using a lymphedema questionnaire focused on physical, psychological,
and social factors, Winters et al. and De Brucker et al. have shown significant improvement in quality of life
after surgery [25,26] . Both authors reported a discontinuation of compression garments in their populations
(40% and 60%, respectively) and a reduction in physiotherapy (60% and 100%, respectively). In patients with
recurrent infections of the arm, Winters and De Brucker also report cessation or reduction following
surgery; however, the population size is limited.
