Tiam Mana Saffari

57 THE SUPERFICIAL INFERIOR EPIGASTRIC ARTERY FASCIA FLAP IN RATS 3 The SIEF flap measured 4 x 3 cm and was designed in the ventral abdomen. After a 4 cm paramedian incision, on the ipsilateral side of the nerve reconstruction, the femoral artery was identified in the groin (Figure 2). The SIE lateral vessels were exposed proximally and protected with a vessel loop. The flap was dissected distally, starting on the medial side. The superficial- and deep membranous layers of subcutaneous tissue (Camper fascia and Scarpa fascia) were separated from the abdominal muscles, leaving the fascia intact. Using microsurgical scissors, the flap was raised toward the proximal branch of the SIE vessels (Figure 3). Figure 3. Schematic drawing of superficial inferior epigastric fascia (SIEF) flap harvest. Depicted is elevating the flap from distal to proximal (A), providing a 4 x 3 cm adipofascial flap (B) with lateral branch of the superficial inferior (SIE) vessels. W ith permission of the Mayo Foundation, Copyright Mayo Foundation 2019 . This dissection was performed under surgical loupe magnification to avoid damage to the SIE vessels. While dissecting, lymph nodes in the inguinal area were seen and preserved. Small vessel branches were anticoagulated using a bipolar as needed to prevent postoperative hematomas. The epigastric nerve was consistently encountered running in conjunction with the SIE vessels and transected in all cases. The flap was