Efficacy of superficial inferior epigastric vein superdrainage in free TRAM and DIEP flap: An indocyanine green angiography study of 68 cases

Zhu, Ying; Yoo, Hyang Keun; Min, Sally; Chang, Hak

doi:10.1016/j.bjps.2023.06.006

Cited by 2 publications

(2 citation statements)

References 42 publications

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“…Twenty-one studies presented data on strategies for when venous supercharging should be performed (Additional file 6 ) [ 9 , 18 , 30 , 33 , 34 , 36 , 39 – 41 , 44 , 46 – 48 , 50 , 52 , 53 , 55 , 58 – 60 ]. Nine [ 18 , 33 , 36 , 40 , 41 , 50 , 52 , 59 , 60 ] of them present radiological signs that could predict venous congestion, four intra-operative measurements [ 30 , 34 , 47 , 53 ] and six [ 9 , 39 , 46 , 48 , 50 , 55 ] clinical signs that could predict the need for venous supercharging. Two studies [ 44 , 58 ] merely give recommendations based on their clinical experience.…”

Section: Resultsmentioning

confidence: 99%

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A systematic review of the scientific evidence of venous supercharging in autologous breast reconstruction with abdominally based flaps

Hansson,

Ramakrishnan,

Morgan

2023

World J Surg Onc

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Background Abdominally based free flaps are commonly used in breast reconstruction. A frequent complication is venous congestion, which might contribute to around 40% of flap failures. One way to deal with it is venous supercharging. The primary aim of this study was to investigate the scientific evidence for the effects of venous supercharging. Methods A systematic literature search was conducted in PubMed, CINAHL, Embase, and Cochrane library. The included articles were critically appraised, and certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Results Thirty-six studies were included. Most studies had serious study limitations and problems with directness. Three studies report ‘routine’ use of venous supercharging and performed it prophylactically in patients who did not have clinical signs of venous congestion. Seventeen studies report on flap complications, of which one is a randomised controlled trial demonstrating statistically significant lower complication rates in the intervention group. The overall certainty of evidence for the effect of a venous supercharging on flap complications, length of hospital stay and operative time, in patients without clinical signs of venous congestion, is very low (GRADE ⊕ ⊕ ⊝ ⊝), and low on and surgical takebacks (GRADE ⊕ ⊕ ⊝ ⊝). Twenty-one studies presented data on strategies and overall certainty of evidence for using radiological findings, preoperative measurements, and clinical risk factors to make decisions on venous supercharging is very low (GRADE ⊕ ⊝ ⊝ ⊝). Conclusion There is little scientific evidence for how to predict in which cases, without clinical signs of venous congestion, venous supercharging should be performed. The complication rate might be lower in patients in which a prophylactic venous anastomosis has been performed. Trial registration PROSPERO (CRD42022353591).

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Section: Resultsmentioning

confidence: 99%

“… ? Zhu, 2023, Republic of Korea [ 60 ] Investigation of the clinical efficacy of the use of SIEV using indocyanine green intraoperatively Non- randomised study (retrospective) P1: 62 ms-TRAMS, 6 DIEPs I4: CTA and indocyanine green NA NR O6. Strategies − + ?…”

Section: Methodsmentioning

confidence: 99%

A systematic review of the scientific evidence of venous supercharging in autologous breast reconstruction with abdominally based flaps

Hansson,

Ramakrishnan,

Morgan

2023

World J Surg Onc

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Electrical stimulation promoting the angiogenesis in diabetic rat perforator flap through attenuating oxidative stress-mediated inflammation and apoptosis

Chen,

Li,

et al. 2024

PeerJ

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Background Skin flap transplantation is one of the effective methods to treat the diabetes-related foot ulceration, but the intrinsic damage to vessels in diabetes mellitus (DM) leads to the necrosis of skin flaps. Therefore, the discovery of a non-invasive and effective approach for promoting the survival of flaps is of the utmost importance. Electrical stimulation (ES) promotes angiogenesis and increases the proliferation, migration, and elongation of endothelial cells, thus being a potential effective method to improve flap survival. Objective The purpose of this study was to elucidate the mechanism used by ES to effectively restore the impaired function of endothelial cells caused by diabetes. Methods A total of 79 adult male Sprague-Dawley rats were used in this study. Gene and protein expression was assessed by PCR and western blotting, respectively. Immunohistochemistry and hematoxylin-eosin staining were performed to evaluate the morphology and density of the microvessels in the flap. Results The optimal duration for preconditioning the flap with ES was 7 days. The flap survival area percentage and microvessels density in the DMES group were markedly increased compared to the DM group. VEGF, MMP2, and MMP9 protein expression was significantly upregulated. ROS intensity was significantly decreased and GSH concentration was increased. The expression of IL-1β, MCP‑1, cleaved caspase-3, and Bax were downregulated in the DMES group, while TGF-β expression was upregulated. Conclusions ES improves the angiogenesis in diabetic ischemic skin flaps by attenuating oxidative stress–mediated inflammation and apoptosis, eventually increasing their viability.

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Efficacy of superficial inferior epigastric vein superdrainage in free TRAM and DIEP flap: An indocyanine green angiography study of 68 cases

Cited by 2 publications

References 42 publications

A systematic review of the scientific evidence of venous supercharging in autologous breast reconstruction with abdominally based flaps

A systematic review of the scientific evidence of venous supercharging in autologous breast reconstruction with abdominally based flaps

Electrical stimulation promoting the angiogenesis in diabetic rat perforator flap through attenuating oxidative stress-mediated inflammation and apoptosis

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