The Use of Retrograde Limb of Internal Mammary Vein in Autologous Breast Reconstruction With DIEAP Flap

Abstract

The retrograde limb of the IMV seems to be a safe alternate recipient vein in DIEAP and muscle sparing free TRAM autologous breast reconstruction. This study does not identify a significant reduction in overall fat necrosis or overall complications when using the 2 venous repair techniques versus the simple venous repair technique.

Use of the retrograde limb of the internal mammary vein to avoid venous congestion in DIEP flap breast reconstruction: Further evidences of a reliable and time‐sparing procedure

“…The retrograde venous drainage of the IMV inferior (or retrograde) limb could be a second recipient vessel for additional venous drainage, as previously described . However, the debate is still ongoing in the literature because of the recent discovery of the presence of valves in the IMV that could interfere with the physiological venous drainage .…”

Benefits of superdrainage using SIEV in DIEP flap breast reconstruction: A systematic review and meta‐analysis

“…Similarly, Lee et al also reported no statistically significant difference in the incidence of total or partial flap loss and fat necrosis between the two groups. In the study by Al‐Dhamin et al the incidence of not only perfusion‐related complications but also other complications including wound infection, dehiscence and hematoma was similar between the superdrainage group and the control group.…”

“…As the experience of DIEP flap breast reconstruction has accumulated and the importance of SIEV in the venous drainage of abdominal flaps has been demonstrated, active applications of SIEV have been attempted, including prophylactic superdrainage using SIEV to reduce the incidence of flap congestion and subsequent complications. Several studies have investigated the potential efficacy of prophylactic venous superdrainage using SIEV . However, none succeeded in demonstrating significant benefits of SIEV superdrainage in reducing the incidence of perfusion‐related complications including total or partial flap loss, although those in decreasing the flap congestion rate were shown by some studies .…”

“…When abstracts of studies met the inclusion criteria, their full text publications were examined further. Eventually, six studies were included and analyzed in this review (Fig. ).…”

“…However, debates as to whether superdrainage can actually prevent perfusion‐related complications are still ongoing in clinical series. In spite of the apparent theoretical underpinning, most previous studies have failed to prove the efficacy of superdrainage on reducing perfusion‐related complications . We hypothesized that this disjunction might be attributable to the limitation of a single‐center study using a small number of cases.…”