Salvage of congested deep inferior epigastric perforator flap with a reverse flow venous anastomosis.
The deep inferior epigastric perforator flap (DIEP) is an increasingly popular method for autologous breast reconstruction because of less abdominal wall donor-site morbidity. However, disadvantages with the DIEP flap are its greater technical difficulties for flap harvest and a greater incidence of venous congestion. We report a case of salvage of a congested DIEP flap with a superficial inferior epigastric vein (SIEV) to deep inferior epigastric vein reverse flow anastomosis. Drainage of both the superficial and deep system resulted in complete reversal of venous congestion and flap salvage. Preservation and use of the SIEV for venous augmentation via a reverse flow anastomosis is a novel and simple method for DIEP flap salvage of venous congestion.
UCLA Medical Center, Department of Surgery, Division of Plastic and Reconstructive Surgery, 200 UCLA Medical Plaza, Los Angeles, CA 90095, USA.
Tom S
TS
Liu
Peter
P
Ashjian
Jaco
J
Festekjian
D000328:Adult; D000714:Anastomosis, Surgical; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D015409:Mastectomy, Radical; D011183:Postoperative Complications / Q000601:surgery*; D012039:Regional Blood Flow; D016879:Salvage Therapy; D013524:Surgical Flaps / Q000098:blood supply*; D014652:Vascular Diseases / Q000601:surgery*