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Veins are an integral part of our circulatory system, serving as the blood vessels that transport blood from all body regions to the heart. They are a network of hollow tubes that carry blood low in oxygen from the body's cells back to the heart for reoxygenation. Veins are crucial for maintaining the body's overall fluid balance and the continuous circulation of blood.
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The Superficial Vein-Only DIEP Flap.

Lauren C Nigro1, Vidya Shankaran1, Payton Miller1

  • 1From the Division of Plastic and Reconstructive Surgery, Mercy Medical Center; Division of Plastic and Reconstructive Surgery and the School of Medicine, Virginia Commonwealth University; and Division of Plastic and Reconstructive Surgery, Dartmouth-Hitchcock Medical Center.

Plastic and Reconstructive Surgery
|July 21, 2022
PubMed
Summary
This summary is machine-generated.

The superficial vein-only deep inferior epigastric artery perforator (DIEP) flap, utilizing the superficial inferior epigastric vein (SIEV) for outflow, offers a reliable alternative for breast reconstruction. This method demonstrated comparable complication rates to standard DIEP flaps, making it a valuable option.

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Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Microsurgery

Background:

  • Deep inferior epigastric artery perforator (DIEP) flaps are standard for autologous breast reconstruction, relying on arterial inflow and venous outflow.
  • Venous outflow is critical for DIEP flap success; the superficial inferior epigastric vein (SIEV) has been used to augment or salvage venous outflow.
  • A variant, the superficial vein-only DIEP flap, uses the deep inferior epigastric artery and the SIEV for outflow.

Purpose of the Study:

  • To describe a variant DIEP flap technique using only the superficial inferior epigastric vein (SIEV) for venous outflow.
  • To evaluate the viability and outcomes of this superficial vein-only DIEP flap in autologous breast reconstruction.

Main Methods:

  • Retrospective review of patients undergoing autologous breast reconstruction from July 2015 to March 2020.
  • Identification of DIEP flaps exclusively using the SIEV for venous outflow, excluding salvage procedures.
  • Analysis of patient and flap characteristics, complications, and harvest details.

Main Results:

  • Thirty patients (35 flaps) were identified with superficial vein-only DIEP flaps.
  • A complication rate of 26.7% was observed, with 62.5% of complications being minor and no flap loss.
  • Complication rates were comparable to the standard DIEP flap population.

Conclusions:

  • The superficial vein-only DIEP flap is a viable and reliable option for selected patients undergoing abdominally based breast reconstruction.
  • This technique provides an additional tool to enhance the success of breast reconstruction.
  • Consideration of the SIEV for superficial vein-only flaps should be part of routine DIEP flap reconstruction planning.