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

Conclusion: ICG lymphangiography facilitated the identification of lymphatic leaks in the groin and
optimized their management in these challenging cases, many of which may have been missed if the area
around the inguinal lymph node basin was treated exclusively.

28. Geometry of wound epithelialization

Michael Gordon

University of Colorado

A mathematical computer model was created to test simple aspects of wound epithelization. Assumptions of the
model included constant production of growth factors from the edge of the wound that diffused across the open
area with a 1/r2 gradient from the cells at the edge of the wound. New cell growth was determined to occur
when an adequate amount of growth factor had accumulated at a point in the open wound area. This model was
then able to predict various characteristics of wound closure: speed of wound closure, effect of size of the wound
on wound closure, shape of wound closure, effect of debridements on wound closure. These predictions were
then tested in the laboratory setting using epithelial cell growth in a petri dish. Excellent agreement between the
mathematical model and the laboratory model was noted. Even the often-noted, but mysterious, slowing down
of wound healing as it approaches closure was observed and explained mathematically.

29. Lumbar artery perforator flap breast reconstruction: achieving good aesthetic results

at both donor and recipient sites

David Greenspun

Greenwich Hospital, Greenwich, Connecticut

The lower abdominal wall is the most commonly used donor site for autologous breast reconstruction. The
thighs and gluteal region are established alternative donor sites for breast reconstruction (PAP, TUG, GAP
flaps) when the abdominal wall does not provide sufficient tissue or is otherwise unsuitable as a result
of prior surgery. Flaps harvested from the buttock or thigh can produce good cosmetic results for the
reconstructed breast, but this is frequently at the expense of unfavorable contour at the donor site. Harvest
of the aforementioned flaps tends to flatten, or make concave, naturally convex surfaces of the body, thus
producing unsatisfactory changes at their respective donor sites. In contradistinction, harvest of lumbar
artery perforator (LAP) flaps, slightly superior to the iliac crest, accentuates the normal lordotic curvature of
the lower back, and therefore produces favorable changes to the donor site contour whilst yielding excellent
tissue for breast reconstruction. Harvest of the LAP flap pedicle is technically demanding and carries high
stakes for donor site morbidity owing to the proximity of the spinal nerves to the vascular pedicle, however,
these flaps can be performed safely and reliably. The routine use of arterial and venous grafts facilitates safe
and efficient flap harvest as well as recipient site microsurgery and flap insetting. A retrospective series will
be presented. With increased experience and good aesthetic results at both the donor and recipient sites, the
LAP flap has emerged as an excellent second-choice flap for breast reconstruction when the abdomen is not
suitable.