Page 55 - Read Online

Plast Aesthet Res 2018;5:6 I http://dx.doi.org/10.20517/2347-9264.2018.08 Page 7 of 17

conducted. The surgeries consisted of complex wound and breast reconstruction performed by the senior
author (C.P.D.) over 4 years at a single institution. Rates of infection, readmission, and reoperation in the
30-day postoperative period were collected.

Results: Of the 83 cases, there were two instances of subsequent surgical site infection (2.4%). A total of 16
reoperations were performed (19%), but in only one case was reoperation required for infectious etiology
(1.2%). Readmission rate following the 83 surgeries was 2.4%. None of the 21 breast-related cases necessitated
reoperation or readmission.

Conclusion: These results lend support to the efficacy of absorbable antibiotic-laden beads in delivering
supratherapeutic and sustained levels of antibiotics to local areas. Their use in complex and infection-prone
wounds may present a valuable addition to the arsenal of plastic and reconstructive surgeons in managing
problematic wounds recalcitrant to standard strategies of debridement and systemic antibiotics.

11. A case report of breast reconstruction with a DCIA-based SIEA free flap

Jonathan Cook, Savannah Moon, Alexander Earle, Miguel Medina

Cleveland Clinic Florida

The superficial inferior epigastric artery (SIEA) flap can be used for autologous breast reconstruction when
a muscle sparing operation is desired. Although the deep circumflex iliac artery (DCIA) flap is one of the
most commonly used flaps for mandibular reconstruction, to our knowledge, this is the first reported case
of a DCIA-based SIEA flap used for breast reconstruction. We report a unique anatomic variant of the
origin of a superficially supplied abdominal flap. The patient was a 66-year-old female, with invasive ductal
carcinoma of the left breast, and lobular carcinoma in situ of the right breast who underwent bilateral
skin sparing mastectomies and immediate autologous reconstruction. The left sided flap demonstrated poor
DIEP perforators on pre-operative CTA and was planned as a likely SIEA flap for the left hemi-abdomen. On
elevation of the left flap the presumed SIE vessels were identified and traced to the left DCIA system. Clinical
perfusion testing and intraoperative ICG fluorescence imaging revealed that the flap was well perfused, and
it was used to support the abdominal flap. The flap was transferred with a good vessel size match and no
complications. On retrospective analysis this vessel was noted to originate from the DCI system on pre-
operative CTA. Although the SIEA usually arises from the circumflex femoral artery, its origin from the
DCIA represents an unusual anatomical variant, which may have been otherwise overlooked as a dominant
perforator. Awareness of this anatomical variant can enable future surgeons to recognize this versatile
muscle-sparing alternative.

12. Work-related physical discomfort in ASCFS and ASMS members: a survey

Ashley L. Howarth, Susan Hallbeck, Valerie Lemaine, Davinder J. Singh, Shelley S. Noland

Mayo Clinic - AZ

Aim: Risks of physical discomfort and injury are high in cranio/maxillofacial surgeons (CMS), who
perform surgeries with headlights and magnification. Identifying the prevalence and impact of work-