Changes in the Microcirculation and Physiologic Perfusion Dynamics of Free DIEP Flaps in the First 72 h After Breast...

Background/Objectives: The autologous reconstruction of the female breast using a microsurgical DIEP flap is a reliable and safe method. To detect impairments early and preserve the microvascular flap through timely revision, a better understanding of physiologic perfusion dynamics is necessary. This exploratory study examines changes in microcirculation in free DIEP flaps within the first 72 h after vascular anastomosis using laser Doppler flowmetry and white-light spectrophotometry. Methods: This single-center study analyzed retro- and prospectively collected data from female patients who underwent uneventful breast reconstruction using a DIEP flap and were monitored using the O2C device (LEA Medizintechnik, Giessen, Germany). Microcirculation was monitored continuously postoperatively for a period of 72 h. Results: A total of 36 patients with a mean age of 48.86 (9.36) years and a mean BMI of 26.78 (4.12) kg/m² received 40 DIEP flaps (four bilateral reconstructions). Microcirculatory blood flow showed a continuous increase, reaching up to 15% above its initial value within the first 72 h following anastomosis. The average tissue oxygen saturation (sO2) and relative hemoglobin (rHB) levels remained fairly stable throughout the study period, with overall reductions of 5.46% and 5.30%, respectively. Conclusions: Autologous breast reconstruction using a microvascular DIEP flap is a safe and reliable technique. This study showed an increase in blood flow over the 72 h study period. At the same time, sO2 and rHb showed stable levels. Deviations in these values could be interpreted as indicators of a perfusion disorder of the microvascular flap.