Novel technique for venous augmentation in a free deep inferior epigastric perforator flap

Venous congestion in a free deep inferior epigastric perforator flap threatens the viability of the flap and can lead to eventual flap loss. We describe a novel technique for flap salvage by anastomosing the ipsilateral superficial inferior epigastric vein to a venae comitantes of the deep inferior epigastric pedicle. When recognized intraoperatively, venous congestion can be relieved immediately without the need for additional dissection of recipient vessels. This technique can also be used during reexploration for flap congestion. We routinely preserve length on the superficial inferior epigastric vein for potential flap salvage.