A quantitative analysis of the venous outflow of the deep inferior epigastric flap (DIEP) based on the perforator veins and the efficiency of superficial inferior epigastric vein (SIEV) supercharging

Rothenberger, Jens; Amr, Amro; Schiefer, Jennifer Lynn; Schaller, Hans-Eberhard; Rahmanian-Schwarz, Afshin

doi:10.1016/j.bjps.2012.08.020

Cited by 32 publications

(42 citation statements)

References 29 publications

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“…Numerous surgical techniques have been reported to promote abdominal flap circulation across midline scars, including bipedicled flaps, retrograde, and contralateral supercharging …”

Section: Discussionmentioning

confidence: 99%

Tips and tricks for DIEP flap breast reconstruction in patients with previous abdominal scar

et al. 2015

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The aim of this study was to analyze outcomes of patients who had prior abdominal operations and underwent DIEP flap breast reconstruction and to describe technical strategies to insure well-vascularized flap-harvest minimizing abdominal donor-site complications. All patients who underwent DIEP flap breast reconstruction between 2004 and 2014 were reviewed and divided into a control group (CG) and a scar group (SG). Patient demographics, operative details, flap and donor-site complications were analyzed and compared. For all of the scars, DIEP flap design was not modified, but a standardized approach was developed according to the type and location of the scar, available vascular pedicle, perforator locations, and the required flap tissue for breast reconstruction. Two hundred and eighty patients underwent 292 flaps in CG and 107 underwent 111 flaps in SG. Pfannenstiel, McBurney, laparoscopic, midline and subcostal were the most common previous incisions. There were no significant differences between groups regarding demographics, flap and mastectomy weight, active smoking, or radiation status (P > 0.05). No significant differences were observed in DIEP flap loss (P = 0.909), partial flap loss (P=0.799), or fat necrosis (P=0.871) and in the rate of abdominal donor-site complications between groups (P > 0.05). SG had a significantly higher mean operative time than CG (P=0.034). Medial raw was a negative risk-factor for flap complications, while BMI (>25.1 kg/m ) and smoking-history were significant predictors for donor-site complications. With careful preoperative planning and appropriate technical strategies, successfully DIEP flap breast reconstruction can be performed without increased flap and donor-site complications in patients with preexisting abdominal scars. © 2015 Wiley Periodicals, Inc. Microsurgery 37:282-292, 2017.

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“…Numerous surgical techniques have been reported to promote abdominal flap circulation across midline scars, including bipedicled flaps, retrograde, and contralateral supercharging …”

Section: Discussionmentioning

confidence: 99%

Tips and tricks for DIEP flap breast reconstruction in patients with previous abdominal scar

et al. 2015

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“…The measurements represent only the nutritive, microvascular vessels because the light is completely absorbed if the vessel diameter is greater than 100 mm [14]. This device has been proven to be a reliable and valid tool in various conditions, such as microvascular flap monitoring [15], flap microperfusion [16], skin perfusion in sore-prone pressure areas [14], determining the need for medical leeches in congested tissues [17], and microcirculatory changes of cold contact injuries [18]. …”

Section: Discussionmentioning

confidence: 99%

Skin Perfusion Changes within 12 h after Axillary Plexus Block

et al. 2017

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Background/Purpose: An improvement of the blood flow would be beneficial in microvascular upper-extremity reconstruction and in digit replantation. In the present work, skin perfusion changes and their duration due to axillary plexus block were quantified. Methods: The peripheral blood flow of the upper extremities in 20 patients undergoing trapeziectomy under axillary plexus block was analyzed. Results: Laser Doppler spectrophotometry was used to measure perfusion factors over a 12-h period, with the contralateral hand acting as the control. Axillary plexus block produced a significant increase of peripheral oxygen saturation (117 ± 35% vs. control 93 ± 22%, p = 0.019), peripheral blood flow (220 ± 166% vs. 130 ± 77%, p = 0.037), and velocity (164 ± 58% vs. 117 ± 45%, p = 0.011). Conclusion: Axillary plexus block produces an improvement of peripheral tissue oxygen saturation of the upper extremities over the first 6 h after the inception of anesthesia. This suggests a potential benefit especially for critically perfused tissues.

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“…[24,25] This salvage procedure decreases venous pressure, increases pressure gradient and overcomes the venous congestion. Adding large caliber venous anastomosis in parallel decrease the risk of venous congestion, because of the ability to provide a superior drainage.…”

Section: Taking Into Account the Redirection Of The Venousmentioning

confidence: 99%

Anatomical features associated with venous congestion in DIEP flap using CT angiography with three-dimensional reconstruction

Ruiz-Moya¹,

Lopez-Garcia²,

Sicilia-Castro³

et al. 2017

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A quantitative analysis of the venous outflow of the deep inferior epigastric flap (DIEP) based on the perforator veins and the efficiency of superficial inferior epigastric vein (SIEV) supercharging

Cited by 32 publications

References 29 publications

Tips and tricks for DIEP flap breast reconstruction in patients with previous abdominal scar

Tips and tricks for DIEP flap breast reconstruction in patients with previous abdominal scar

Skin Perfusion Changes within 12 h after Axillary Plexus Block

Anatomical features associated with venous congestion in DIEP flap using CT angiography with three-dimensional reconstruction

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