Journal of Japanese Society of Reconstructive Microsurgery
Online ISSN : 2185-9949
Print ISSN : 0916-4936
ISSN-L : 2185-9949
Original Article
Breast Reconstruction Using a DIEP Flap and an Alternative Venous Outflow System
Yoshihiro SOWATakuya KODAMAKoichi SAKAGUCHITetsuya TAGUCHIToshiaki NUMAJIRI
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2020 Volume 33 Issue 3 Pages 145-151

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Abstract

Breast reconstruction using a deep inferior epigastric perforator flap (DIEP flap) harvested from beyond the midline of the abdomen often causes postoperative partial congestion and fat induration in the flap. In such cases, we prophylactically preserve the superficial epigastric veins (SEVs) and perforator vein of the flap, and add a venous outflow system by anastomosis of a combination of candidate intra-flap veins and the inferior epigastric vein to reduce flap congestion when intraoperative findings suggest flap congestion. As a result, fat necrosis was avoided in all 12 cases in which flap congestion was prevented. When intra-flap vein anastomosis is added, appropriate selection of a target vein is required depending on the anatomical position of the blood vessel in each case. The above measures do not require a new arterial anastomosis and may be able to prevent postoperative flap congestion with a relatively simple procedure.

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© 2020 Japanese Society of Reconstructive Microsurgery
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