The role of superdrainage using superficial inferior epigastric vein in single-pedicled deep inferior epigastric perforator flap breast reconstruction
10.3760/cma.j.cn114453-20220923-00291
- VernacularTitle:腹壁浅静脉超回流在单蒂腹壁下动脉穿支皮瓣乳房再造中的作用
- Author:
Xiaomu MA
1
;
Boyang XU
;
Su FU
;
Shangshan LI
;
Wenyue LIU
;
Xingyi DU
;
Yiye OUYANG
;
Jie LUAN
;
Chunjun LIU
Author Information
1. 中国医学科学院北京协和医学院整形外科医院乳腺综合整形科，北京 100144
- Keywords:
Surgical flaps;
Deep inferior epigastric perforator;
Superficial inferior epigastric vein;
Breast reconstruction;
Superdrainage
- From:
Chinese Journal of Plastic Surgery
2023;39(4):366-374
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the safety and efficacy of prophylactic superdrainage using superficial inferior epigastric vein (SIEV) in delayed single-pedicled deep inferior epigastric perforator (DIEP) flap breast reconstruction.Methods:The clinical data of all patients who underwent single-pedicle DIEP flap delayed breast reconstruction in Department of Comprehensive Breast Plasty Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from May 2018 to August 2022 were retrospectively analyzed. According to whether SIEV-internal thoracic vein anastomosis was performed, they were divided into superdrainaged group and non-superdrainaged group. The diameter of SIEV and the time required for anastomosis were recorded. The total operation time, flap ischemia time, hospital stay, the rates of flap diffuse congestion, overall complications and second operation were compared between the two groups. The relative risks of flap diffuse congestion, complications and second operation were calculated. SPSS 24.0 software was used for data analysis. Measurement data was expressed as Mean±SD, independent sample t test was used for analysis. Counting data was expressed as %, and χ2 test was used for analysis. P<0.05 was considered statistically significant. Results:A total of 45 patients were included, including 26 patients in the non-superdrainaged group and 19 patients in the superdrainaged group. The total operation time was (7.7±1.9) h and (8.4±1.5) h, the flap ischemia time was (89.5±10.4) min and (92.6±12.3) min, and the hospital stay was (6.6±1.8) d and (6.6±2.0) d, respectively. There were no significant differences ( P>0.05). In the superdrainaged group, the diameter of SIEV was (2.5±0.3) mm, and manual suture was used. The time required for anastomosis of one SIEV was (12.2±2.3) min. The rates of diffuse congestion, recipient site complications, donor site complications and second operation were 7.7%(2/26), 15.4%(4/26), 7.7%(2/26) and 15.4%(4/26) in the non-superdrainaged group, and 0(0/19), 5.3%(1/19), 10.5%(2/19) and 5.3%(1/19) in the superdrainaged group, respectively. There were no significant differences between the two groups ( P>0.05). The relative risks were 3.7, 2.9, 0.7 and 2.9, respectively. Conclusion:Prophylactic superdrainage using SIEV is safe and effective. It can minimize the potential rate of diffuse venous congestion and secondary surgery, and not at the expense of increased flap ischemia time and abdominal complications in the meanwhile.
