Artikel
Effect of venous supercharging in the venous drainage of DIEP flap
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Veröffentlicht: | 27. September 2011 |
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Introduction: While the arterial perfusion of the anterior abdominal wall has been extensively described in previous works, little has been published on the venous drainage of the Deep Inferior Epigastric Flap (DIEP). The present study was performed to get a better understanding of the venous drainage, which remains the more common vascular complication of this flap.
Materials and methods: We assessed the perfusion dynamics and the efficacy of venous outflow on 19 patients undergoing DIEP flap breast reconstruction, determining relative haemoglobin concentration (rHB). After the flap had been isolated on the perforator vessels, measurements were carried using the micro-lightguide spectrophotometer O2C. Additionally, the efficacy of venous supercharging of the superficial inferior epigastric vein (SIEV) was evaluated. For the sake of convenience, we applied the classic perfusion zones as suggested by Hartrampf, knowing that it relates to TRAM flap.
Results: Based on a single perforator vein, zone IV had the least venous outflow and we observed the highest drainage in zone I. There was no significant difference between the venous drainage of the two immediately adjacent zones II and III. Supercharging with the contralateral SIEV showed a significantly better venous drainage of the contralateral zones II and IV, whereas the ipsilateral SIEV did not present a significant improvement of venous drainage of any zone.
Conclusions: This study illustrates a new insight on the characteristics of the venous outflow DIEP flap. Based on our findings, we believe that the supercharging of the contralateral SIEV leads to an improved venous outflow and thus a higher flap survival by reduction of venous congestion.