دورية أكاديمية
An Algorithmic Approach to Dual-System Venous Drainage for DIEP Flap Breast Reconstruction.
| العنوان: | An Algorithmic Approach to Dual-System Venous Drainage for DIEP Flap Breast Reconstruction. |
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| المؤلفون: | Jabbour S; From the Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital., Youn R; From the Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital., Kim KG; From the Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital., Tirrell AR; Georgetown University School of Medicine., Harbour PW; From the Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital., Dekker PK; Georgetown University School of Medicine., Fan KL; From the Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital., Song DH; From the Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital. |
| المصدر: | Plastic and reconstructive surgery [Plast Reconstr Surg] 2024 Jul 01; Vol. 154 (1), pp. 1e-12e. Date of Electronic Publication: 2023 Jul 17. |
| نوع المنشور: | Journal Article; Comparative Study |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 1306050 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1529-4242 (Electronic) Linking ISSN: 00321052 NLM ISO Abbreviation: Plast Reconstr Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Original Publication: Baltimore : Williams & Wilkins, |
| مواضيع طبية MeSH: | Mammaplasty*/methods , Mammaplasty*/adverse effects , Perforator Flap*/blood supply , Perforator Flap*/transplantation , Algorithms* , Epigastric Arteries*/transplantation, Humans ; Female ; Retrospective Studies ; Middle Aged ; Adult ; Drainage/methods ; Postoperative Complications/etiology ; Postoperative Complications/prevention & control ; Postoperative Complications/epidemiology ; Veins/surgery ; Breast Neoplasms/surgery ; Operative Time ; Graft Survival |
| مستخلص: | Background: Few studies compared the use of the deep venous system alone versus combined superficial and deep venous drainage in deep inferior epigastric perforator (DIEP) flaps. The objective of this study was to compare DIEP flap breast reconstruction using either the deep venous system alone versus dual-system venous drainage and to propose an algorithm for flap design and orientation and vein selection to facilitate consistent use of dual-system venous drainage. Methods: Patients undergoing DIEP flap breast reconstruction between March of 2017 and April of 2021 were reviewed retrospectively. Flaps were divided into 2 groups: deep venous system only (group 1) or dual system (group 2). Outcomes included take-back to the operating room, flap loss and thrombosis, and operative time. Results: A total of 244 DIEP flaps in 162 patients met inclusion criteria. A total of 130 flaps were included in group 1 (53.3%) and 114 flaps were included in group 2 (46.7%). Sixteen flaps (6.6%) required immediate take-back to the operating room, and take-back rates were not significantly different between groups ( P = 0.606). The flap loss rate was significantly higher in group 1 at 2.5% versus group 2 at 0% ( P = 0.031). Flap thrombosis occurred in 8 flaps (3.3%) and tended to occur more frequently in group 1, but this finding did not reach significance (group 1, 5.4%; group 2, 0.9%; P = 0.071). Conclusions: The use of dual-system venous drainage in DIEP flap breast reconstruction decreases the rate of flap loss. The authors' algorithm can be used to guide selection of flap laterality, rotation, and veins and recipient vessels to facilitate routine use of dual-system venous drainage. Clinical Question/level of Evidence: Therapeutic, III. (Copyright © 2023 by the American Society of Plastic Surgeons.) |
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| تواريخ الأحداث: | Date Created: 20230719 Date Completed: 20240626 Latest Revision: 20240715 |
| رمز التحديث: | 20240715 |
| DOI: | 10.1097/PRS.0000000000010927 |
| PMID: | 37467054 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1529-4242 |
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| DOI: | 10.1097/PRS.0000000000010927 |