Table 5.
The Malata–Rabey comprehensive classification of double pedicled abdominal free flap anastomoses.
| A. Intraflap anastomoses |
|---|
| Type I SIEA – SIEA |
| Type II SIEA – DIEP |
| a. Inferior continuity |
| b. Superior continuity |
| c. Combination inferior and superior (vein and artery) |
| Type III DIEP – DIEP |
| a. Inferior continuity |
| b. Superior continuity |
| c. Combination of inferior and superior (vein and artery) |
| Type IV DIEP – DIEP Perforator (left or right) |
| a. Inferior continuity (unlikely unless centrally located and long IC) |
| b. Superior continuity |
| c. Combination of inferior and superior (artery and vein): highly unlikely |
| Type V DIEP – DIEP |
| a. End-to-side anastomosis (artery alone) (vein to vena comitans) |
| b. End-to-side anastomosis (artery and vein) |
| B. Extra-flap anastomoses |
| Type I To a single recipient site: IMVs |
| a. Flap 1 (both vessels antegrade); Flap 2 (artery retrograde, vein antegrade to second vc) |
| b. Flap 1 (both vessels antegrade); Flap 2 (both artery and vein retrograde) |
| Type II To a single recipient site: thoracodorsal system |
| a. Flap 1 (both vessels antegrade); Flap 2 (artery retrograde, vein antegrade to vc) |
| b. Flap 1 (both vessels antegrade); Flap 2 (both retrograde) – unlikely |
| Type III To two separate recipient sites |
| a. IMVs and subscapular-thoracodorsal system (preferably above serratus branch) |
| b. IMVs and pectoral vessels (unlikely) |
| c. IMVs and other vessels (cephalic vein loop, etc) – when in “trouble” |
| C. Combined intraflap and extra-flap anastomoses |