Avoidance of complications after the use of deep inferior epigastric perforator flaps for reconstruction of the breast

Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery
Jonas Lundberg, Hans Mark

Abstract

We assessed 50 consecutive unilateral deep inferior epigastric perforator (DIEP) flaps for breast reconstruction to find out our morbidity and how to avoid it. We routinely dissected the superficial epigastric vein bilaterally and perforators ipsilaterally. If there were insufficient perforators on the ipsilateral side, we then dissected the contralateral side. We made an additional anastomosis to the superficial epigastric vein in cases of venous congestion after reperfusion that could threaten flap survival. One perforator was used on 31 occasions, and the contralateral side was dissected in 16. A prophylactic anastomosis of superficial epigastric vein was done in 3. No flap was lost completely but 5 partially necrosed. A comparison of the first 25 and the second 25 flaps showed more dissections of the contralateral side and more prophylactic anastomoses of the superficial epigastric vein in the second 25. Partial necrosis was less common in the second 25. We suggest that more liberal dissection of the contralateral side and the prophylactic anastomosis of the superficial epigastric vein to lower morbidity and give better cosmetic results.

References

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Citations

Sep 12, 2015·Journal of Plastic Surgery and Hand Surgery·Andri ThorarinssonHans Mark
Mar 20, 2012·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Andrea FigusVenkat V Ramakrishnan
Jun 28, 2011·Plastic and Reconstructive Surgery·Mark V SchaverienStephen J McCulley
Jan 15, 2008·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·W M RozenG I Taylor
Sep 5, 2009·Plastic and Reconstructive Surgery·Warren M RozenMark W Ashton
Apr 4, 2009·Plastic and Reconstructive Surgery·Li-Xing ManJoseph M Serletti
Apr 21, 2011·Journal of Plastic Surgery and Hand Surgery·Ziyin ShangBanghe Wang
Jun 26, 2009·The Canadian Journal of Plastic Surgery = Journal Canadien De Chirurgie Plastique·Achilleas ThomaEric Duku P Stat

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