Use of a second 'exit-vein' so to speak, allows the surgeon to salvage the flap and continue with a successful breast reconstruction.
San Antonio, TX (PRWEB) November 19, 2013
A new study by PRMA Plastic Surgery uncovers a technique that prevents complications in breast reconstruction.
The study, published in Plastic & Reconstructive Surgery Global Open in October, finds that the use of a second vein during DIEP flap surgery, a procedure that rebuilds the patient’s breasts after mastectomy using her own tummy skin and fat, can significantly reduce the risk of flap loss.
“Sometimes we come across patients that develop what we call congestion in the DIEP flap” says Dr. Steven Pisano of PRMA. “When this happens, the flap turns purple. This basically means that blood is getting into the flap but is pooling in the tissue instead of flowing back out. This "back-up" of blood can ultimately lead to flap loss and failure of the reconstruction.”
Pisano says that the use of a second ‘exit-vein’ so to speak, allows the surgeon to save the flap and ensure a successful breast reconstruction.
The study, which analyzed 1616 patients, showed that the percentage of cases where the surgeon had to use the second vein was about 3.3%. Dr. Pisano said however, that since the publication of the paper, the percentage of flaps where a second vein is used is now 5-10% because the surgeons have gained further experience recognizing the very earliest, most subtle signs of venous congestion.
“What our study has taught us is that if we now notice during surgery that the patient's blood vessels may not support the flap, we go ahead and use a second vein,” said Pisano. “This prevents the possibility of flap loss within the first couple of days after surgery due to congestion that wasn't obvious in the operating room.”
PRMA is one of the largest plastic surgery groups in the US specializing in breast reconstruction. PRMA specializes in microsurgical flap procedures like the DIEP flap that use only the patient’s skin and fat while preserving muscle. PRMA performs over 500 DIEP flaps per year with a success rate over 99%.
PRMA Plastic Surgery in San Antonio, Texas, specializes in state-of-the-art breast reconstruction. Procedures offered include the DIEP flap, SIEA flap, GAP flap, TUG flap, fat grafting, Alloderm One-Step, vascularized lymph node transfer and nipple-sparing mastectomy. PRMA is In-Network for most US insurance plans and routinely welcomes patients from across and outside the US. Connect with other patients in our breast reconstruction community on Facebook.