Background: In autologous tissue breast reconstruction, recipient vessels are important for artery perfusion and venous drainage to ensure free flap survival. There are insufficient clinical outcomes to select efficient recipient vessels in bipedicled deep inferior epigastric perforators (DIEP) flap reconstruction.
Methods: We presented a retrospective observational series of 108 patients regarding the diameter, anastomosis time, and re-anastomosis rate in internal mammary (IM), circumflex scapular (CS), thoracodorsal (TD), thoracoacromial (TA), lateral thoracic (LT), and internal mammary perforators (IMP) vessels of bi-pedicle DIEP flap for breast reconstruction after mastectomy. The outcomes were the vessel re-anastomosis rate, flap failure rate, vessel anastomosis time, and complications. Data were gleaned from the chi-square test, Fishers’, and analysis of variance using Scheffe’s test as a post-hoc analysis. The level of significance was P < 0.05.
Results: There were no significant differences in the diameters of the artery, first and secondary veins recipient vessels (p > 0.05). However, the anastomosis time was longer in IM and TA than in CS, TD, and LT (p < 0.001). Also, there were no significant differences for re-anastomosis, flap necrosis, and fat necrosis among different recipient vessels (p > 0.05).
Conclusions: Due to the altered mastectomy incisions, this study provides complete anatomical vascular properties and suggests that altering recipient vessel selection for bipedicled DIEP flaps can shorten anastomosis time and better conceal scars.

Key Word: Recipient vessels, Selection, DIEP flap, Breast reconstruction

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