J Reconstr Microsurg 2010; 26(2): 103-107
DOI: 10.1055/s-0029-1243294
© Thieme Medical Publishers

Measuring the Pressure in the Superficial Inferior Epigastric Vein to Monitor for Venous Congestion in Deep Inferior Epigastric Artery Perforator Breast Reconstructions: A Pilot Study

Jeroen M. Smit1 , 2 , Thorir Audolfsson1 , Iain S. Whitaker3 , Paul M.N Werker4 , Rafael Acosta1 , Anders G. Liss1
  • 1Department of Plastic and Reconstructive Surgery, Uppsala University Hospital, Uppsala, Sweden
  • 2Department of Plastic and Reconstructive Surgery, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
  • 3Department of Plastic and Reconstructive Surgery, Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, United Kingdom
  • 4Department of Plastic and Reconstructive Surgery, University Medical Center Groningen, Groningen, The Netherlands
Further Information

Publication History

Publication Date:
10 December 2009 (online)

ABSTRACT

During deep inferior epigastric artery perforator (DIEP) flap dissection, we noted that in many cases the superficial vein on the ipsilateral side of the flap was engorged and tense, and in others, it was empty. This led us to believe that the pressure is increased as the result of preferential outflow through the superficial vein in some cases, which could result in venous congestion of the flap if this vessel was not anastomosed. To test this hypothesis, we measured the venous pressure in the superficial venous system before and after flap dissection. The pressure in the superficial inferior epigastic vein of a DIEP flap was measured in 26 consecutive flaps to investigate the correlation between the pressure and venous congestion of the flap. The first measurement was performed at the beginning of the dissection, and the second measurement was taken after the flap had been completely raised on a single perforator. The mean increase in pressure after flap dissection was 10.6 mm Hg (μ = 10.6; range −1 to 31; Ó ± 7.0 mm Hg). Clinical signs of venous congestion were observed in one case. In this case, the increase in venous pressure was with 31 mm Hg, also the highest. Although the results of this report are preliminary, they indicate that the pressure in the superficial vein of DIEP flaps might be of predictive value for venous congestion.

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Anders G LissM.D. Ph.D. 

Department of Plastic and Reconstructive Surgery, Uppsala University Hospital

SE-751 85 Uppsala, Sweden

Email: jermasmit@gmail.com

Email: info@lissliss.se