Abstract: Objective To introduce three different intra-flap anastomosis in reconstruction of the blood supply on double pedicle deep inferior epigastric perforator(DIEP) flap and to compare the outcomes of the three methods.Methods Eighty seven patients who received breast reconstruction by double pedicle DIEP flap in our department from January 2004 to December 2008 were reviewed.Three different intra-flap anastomosis in reconstruction the blood supply on double pedicle DIEP flap were performed.Thirty eight patients were performed the distal end to end anastomosis,20 patients were performed the lateral branch style and 29 patients were performed the end-to-side style.The operation time,postoperative vascular complications,flap loss,partial flap loss and fat necrosis of the three styles were analyzed.Results The length and width of the flap of the three groups had no statistical differences and so did the operation time.The follow up period ranged from 6 months to 60 months.2 patients of the distal end to end anastomosis,1 patient of the lateral branch style group and 1 patient of the end-to-side style group occurred postoperative vascular complications.There was no flap loss all of the three groups.One flap of the lateral branch style group developed partial flap loss.3 patients of the distal end to end anastomosis group,4 patients of the lateral branch style group and 4 patients of the end-to-side style group were found fat necrosis three months after operation.Conclusion The three styles of intra-flap anastomosis are all good methods for reconstruction of blood supply on double pedicle DIEP flap and can be used in all situations.The three methods have no differences in operation time,postoperative vascular complications and the capability of the blood supply of double pedicle DIEP flap reconstruction.

Key words: Breast neoplasm, Flap, Blood supply, Reconstructive surgical procedure