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J Reconstr Microsurg 2011; 27(4): 233-238
DOI: 10.1055/s-0031-1275486
© Thieme Medical Publishers

Predictors of Blood Transfusion in Deep Inferior Epigastric Artery Perforator Flap Breast Reconstruction

Jeannette Ting1 , [*] , Warren M. Rozen1 , [*] , Cara Michelle Le Roux1 , [*] , Mark W. Ashton1 , [*] , Emilio Garcia-Tutor1 , [*]
  • 1Department of Anatomy and Cell Biology, Jack Brockhoff Reconstructive Plastic Surgery Research Unit, The University of Melbourne, Victoria, Australia
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Publication History

Publication Date:
30 March 2011 (online)

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ABSTRACT

Perioperative blood loss during and following breast reconstruction surgery can have substantial impact on free flap survival and patient morbidity. Transfusion rates of up to 95% have been reported following transverse rectus abdominis myocutaneous flap breast reconstruction, with blood loss described as significant in most cases. However, there has been little reported of such requirements in patients undergoing deep inferior epigastric perforator (DIEP) flap breast reconstruction. We present the transfusion requirements of 152 consecutive patients who underwent DIEP flap breast reconstruction, with a view to quantifying transfusion requirements and identifying risk factors for such loss. In this cohort, 80.3% of patients required blood transfusion, with a mean volume of 3.9 U per patient. There was a statistically significant correlation for increased transfusion requirement in patients with preoperative anemia (p < 0.001) and in bilateral cases (p < 0.001), but not for cases of immediate reconstruction (p = 0.72). Although blood loss in breast reconstructive surgery is rarely large enough to be life-threatening, relative anemia does have significant effect on flap survival and patient morbidity. With risk factors for increased transfusion requirements identified in the current study, high-risk patients can be predicted preoperatively.

KEYWORDS

Blood loss - abdominal wall - perforator flap - bleeding - free flap - complications

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1 All authors contributed significantly to this work.

Warren M RozenM.B.B.S. B.Med.Sc. P.G.Dip.Surg.Anat. Ph.D. 

Jack Brockhoff Reconstructive Plastic Surgery Research Unit, Room E533, Department of Anatomy and Cell Biology, The University of Melbourne

Grattan Street, Parkville, 3050, Victoria, Australia

Email: warrenrozen@hotmail.com