A method using the cephalic vein for superdrainage in breast reconstruction.

Area of Science:

• Plastic Surgery
• Microsurgery
• Breast Reconstruction

Background:

• Superdrainage in breast reconstruction utilizes the superficial inferior epigastric vein.
• Investigating alternative recipient veins is crucial for successful outcomes.

Purpose of the Study:

• To compare the efficacy of the cephalic vein (CV) against the serratus anterior muscle branch (SA) and lateral thoracic vein (LTV) as recipient vessels in superdrainage procedures for breast reconstruction.

Main Methods:

• Eighty-eight patients undergoing breast reconstruction with superdrainage were analyzed.
• The SA or LTV was prioritized as the recipient vein; CV was used if both were unsuitable.
• Superdrainage was withheld if the internal mammary vein diameter exceeded the deep inferior epigastric vein diameter.

Main Results:

• Superdrainage was performed in 51.1% of patients, with no significant difference in outcomes compared to those without.
• The CV was used in 15.5% of superdrainage cases.
• Patients receiving CV experienced higher re-exploration rates (28.6% vs. 0%) and longer operating times (652.1 vs. 591.1 min) compared to SA/LTV groups (p < .05).
• No complications were attributed to CV harvesting.

Conclusions:

• The cephalic vein (CV) demonstrates equivalent utility to the SA and LTV as a recipient vein in superdrainage for breast reconstruction.
• CV is essential only in rare cases but its potential use should be considered.
• Prioritizing SA or LTV can reduce re-exploration and operative time.