Anastomosis of the Superficial Inferior Epigastric Vein to the Internal Mammary Vein to Augment Deep Inferior Artery Perforator Flaps.
Use of the retrograde limb of the internal mammary vein has been described previously as a lifeboat for venous congestion but not prophylactically. Maximizing the length of the deep inferior artery perforator (DIEP) flap pedicle, identifying and dissecting the superficial inferior epigastric vein proximally in every patient, and taking advantage of the retrograde internal mammary vein are all technical details that facilitate the additional venous anastomosis and flap inset. Performing a second venous anastomosis routinely using the superficial inferior epigastric vein to the retrograde internal mammary vein helps with flap inset.
Division of Plastic and Reconstructive Surgery, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. Electronic address: Vijayasekaran.Aparna@mayo.edu.
Aparna
A
Vijayasekaran
Division of Plastic and Reconstructive Surgery, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
Anita T
AT
Mohan
Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China.
Lin
L
Zhu
Division of Plastic and Reconstructive Surgery, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
Basel
B
Sharaf
Division of Plastic Surgery, Baylor Scott & White Health, Scott & White Memorial Hospital, MS-01-E443, 2401 South 31st Street, Temple, TX 76508, USA.
Michel
M
Saint-Cyr
D000714:Anastomosis, Surgical; D001158:Arteries / Q000601:surgery*; D005260:Female; D006801:Humans; D016462:Mammaplasty; D061525:Perforator Flap / Q000098:blood supply*; D014680:Veins / Q000601:surgery*
Deep inferior artery perforator flap; Venous augmentation; Venous congestion