Cargando…

A Novel Strategy to Supercharge a Deep Inferior Epigastric Artery Perforator Flap after Port-a-Cath Removal

Autologous breast reconstruction using the deep inferior epigastric artery perforator (DIEP) flap has become increasingly popular because of its unique advantages. However, compared with some other forms of abdominal-based autologous reconstruction, DIEP flaps are associated with an increased risk o...

Descripción completa

Detalles Bibliográficos
Autores principales: Teven, Chad M., Ooi, Adrian S.H., Chang, David W., Song, David H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5222634/
https://www.ncbi.nlm.nih.gov/pubmed/28293489
http://dx.doi.org/10.1097/GOX.0000000000001031
_version_ 1782493042874253312
author Teven, Chad M.
Ooi, Adrian S.H.
Chang, David W.
Song, David H.
author_facet Teven, Chad M.
Ooi, Adrian S.H.
Chang, David W.
Song, David H.
author_sort Teven, Chad M.
collection PubMed
description Autologous breast reconstruction using the deep inferior epigastric artery perforator (DIEP) flap has become increasingly popular because of its unique advantages. However, compared with some other forms of abdominal-based autologous reconstruction, DIEP flaps are associated with an increased risk of venous congestion. Many techniques—or lifeboats—have been introduced to diagnose and treat this potentially devastating complication. In this case report, we describe a novel strategy to augment venous drainage when venous congestion is encountered. A patient presented requesting autologous reconstruction and removal of a venous access catheter that had been used for chemotherapy administration. We performed left delayed breast reconstruction using a single-perforator DIEP flap from the right hemiabdomen. The superficial inferior epigastric vein to this flap was preserved. After removal of the Port-a-Cath from the left chest, we anastomosed the superficial inferior epigastric vein to the fibrous capsular sheath that had formed around the indwelling catheter to allow additional venous drainage. Flow through this conduit was confirmed using Doppler ultrasound. There were no flap-related complications, and the patient was discharged in good condition. Further research is warranted to characterize the indications and limitations of this novel lifeboat.
format Online
Article
Text
id pubmed-5222634
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Wolters Kluwer Health
record_format MEDLINE/PubMed
spelling pubmed-52226342017-03-14 A Novel Strategy to Supercharge a Deep Inferior Epigastric Artery Perforator Flap after Port-a-Cath Removal Teven, Chad M. Ooi, Adrian S.H. Chang, David W. Song, David H. Plast Reconstr Surg Glob Open Case Report Autologous breast reconstruction using the deep inferior epigastric artery perforator (DIEP) flap has become increasingly popular because of its unique advantages. However, compared with some other forms of abdominal-based autologous reconstruction, DIEP flaps are associated with an increased risk of venous congestion. Many techniques—or lifeboats—have been introduced to diagnose and treat this potentially devastating complication. In this case report, we describe a novel strategy to augment venous drainage when venous congestion is encountered. A patient presented requesting autologous reconstruction and removal of a venous access catheter that had been used for chemotherapy administration. We performed left delayed breast reconstruction using a single-perforator DIEP flap from the right hemiabdomen. The superficial inferior epigastric vein to this flap was preserved. After removal of the Port-a-Cath from the left chest, we anastomosed the superficial inferior epigastric vein to the fibrous capsular sheath that had formed around the indwelling catheter to allow additional venous drainage. Flow through this conduit was confirmed using Doppler ultrasound. There were no flap-related complications, and the patient was discharged in good condition. Further research is warranted to characterize the indications and limitations of this novel lifeboat. Wolters Kluwer Health 2016-12-29 /pmc/articles/PMC5222634/ /pubmed/28293489 http://dx.doi.org/10.1097/GOX.0000000000001031 Text en Copyright © 2016 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. All rights reserved. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Case Report
Teven, Chad M.
Ooi, Adrian S.H.
Chang, David W.
Song, David H.
A Novel Strategy to Supercharge a Deep Inferior Epigastric Artery Perforator Flap after Port-a-Cath Removal
title A Novel Strategy to Supercharge a Deep Inferior Epigastric Artery Perforator Flap after Port-a-Cath Removal
title_full A Novel Strategy to Supercharge a Deep Inferior Epigastric Artery Perforator Flap after Port-a-Cath Removal
title_fullStr A Novel Strategy to Supercharge a Deep Inferior Epigastric Artery Perforator Flap after Port-a-Cath Removal
title_full_unstemmed A Novel Strategy to Supercharge a Deep Inferior Epigastric Artery Perforator Flap after Port-a-Cath Removal
title_short A Novel Strategy to Supercharge a Deep Inferior Epigastric Artery Perforator Flap after Port-a-Cath Removal
title_sort novel strategy to supercharge a deep inferior epigastric artery perforator flap after port-a-cath removal
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5222634/
https://www.ncbi.nlm.nih.gov/pubmed/28293489
http://dx.doi.org/10.1097/GOX.0000000000001031
work_keys_str_mv AT tevenchadm anovelstrategytosuperchargeadeepinferiorepigastricarteryperforatorflapafterportacathremoval
AT ooiadriansh anovelstrategytosuperchargeadeepinferiorepigastricarteryperforatorflapafterportacathremoval
AT changdavidw anovelstrategytosuperchargeadeepinferiorepigastricarteryperforatorflapafterportacathremoval
AT songdavidh anovelstrategytosuperchargeadeepinferiorepigastricarteryperforatorflapafterportacathremoval
AT tevenchadm novelstrategytosuperchargeadeepinferiorepigastricarteryperforatorflapafterportacathremoval
AT ooiadriansh novelstrategytosuperchargeadeepinferiorepigastricarteryperforatorflapafterportacathremoval
AT changdavidw novelstrategytosuperchargeadeepinferiorepigastricarteryperforatorflapafterportacathremoval
AT songdavidh novelstrategytosuperchargeadeepinferiorepigastricarteryperforatorflapafterportacathremoval