| A single center comparison of one versus two venous anastomoses in 564 consecutive DIEP flaps: investigating the effect on venous congestion and flap survival. | |
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MedLine Citation:
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PMID: 19790180 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Venous complications have been reported as the more frequently encountered vascular complications seen in the transfer of deep inferior epigastric artery (DIEA) perforator (DIEP) flaps, with a variety of techniques described for augmenting the venous drainage of these flaps to minimize venous congestion. The benefits of such techniques have not been shown to be of clinical benefit on a large scale due to the small number of cases in published series. METHODS: A retrospective study of 564 consecutive DIEP flaps at a single institution was undertaken, comparing the prospective use of one venous anastomosis (273 cases) to two anastomoses (291 cases). The secondary donor vein comprised a second DIEA venae commitante in 7.9% of cases and a superficial inferior epigastric vein (SIEV) in 92.1%. Clinical outcomes were assessed, in particular rates of venous congestion. RESULTS: The use of two venous anastomoses resulted in a significant reduction in the number of cases of venous congestion to zero (0 vs. 7, P = 0.006). All other outcomes were similar between groups. Notably, the use of a secondary vein did not result in any significant increase in operative time (385 minutes vs. 383 minutes, P = 0.57). CONCLUSIONS: The use of a secondary vein in the drainage of a DIEP flap can significantly reduce the incidence of venous congestion, with no detriment to complication rates. Consideration of incorporating both the superficial and deep venous systems is an approach that may further improve the venous drainage of the flap. |
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Authors:
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Morteza Enajat; Warren M Rozen; Iain S Whitaker; Jeroen M Smit; Rafael Acosta |
Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Microsurgery Volume: 30 ISSN: 1098-2752 ISO Abbreviation: Microsurgery Publication Date: 2010 |
Date Detail:
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Created Date: 2010-03-16 Completed Date: 2010-06-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8309230 Medline TA: Microsurgery Country: United States |
Other Details:
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Languages: eng Pagination: 185-91 Citation Subset: IM |
Affiliation:
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Department of Plastic Surgery, Uppsala Clinic Hospital, Uppsala 75185, Sweden. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anastomosis, Surgical Humans Mammaplasty Retrospective Studies Surgical Flaps / blood supply* Tissue Survival Vascular Surgical Procedures Veins / surgery* Venous Insufficiency / prevention & control* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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