Communication: predicting venous insufficiency in flaps raised on the deep inferior epigastric system using computed tomography (CT) angiography

Wagels, M., Pillay, R., Saylor, A., Vrtik, L. and Senewiratne, S. (2015) Communication: predicting venous insufficiency in flaps raised on the deep inferior epigastric system using computed tomography (CT) angiography. Journal of Plastic, Reconstructive and Aesthetic Surgery, 68 12: e200-e202. doi:10.1016/j.bjps.2015.08.017

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Author Wagels, M.
Pillay, R.
Saylor, A.
Vrtik, L.
Senewiratne, S.
Title Communication: predicting venous insufficiency in flaps raised on the deep inferior epigastric system using computed tomography (CT) angiography
Journal name Journal of Plastic, Reconstructive and Aesthetic Surgery   Check publisher's open access policy
ISSN 1878-0539
1748-6815
Publication date 2015-12-01
Year available 2015
Sub-type Article (original research)
DOI 10.1016/j.bjps.2015.08.017
Open Access Status Not Open Access
Volume 68
Issue 12
Start page e200
End page e202
Total pages 3
Place of publication London, United Kingdom
Publisher Churchill Livingstone
Collection year 2016
Language eng
Abstract Computed Tomography Angiogram (CTA) has become a routine part of pre-operative assessment of vascular anatomy and design in perforator flaps. We conducted a retrospective cohort study of flap raised on the deep inferior epigastric system (DIES) at our institution in order to identify CTA signs that might predict venous congestion in these flaps. 98 consecutive patients who had 124 DIES flaps raised from 2008 to 2012 were studied. Of these 124 flaps, four (3.2%) developed venous congestion. Our results showed that a Superficial Inferior Epigastric Vein (SIEV) that is larger than the DIEV at origin is highly predictive of congestion (5.2 vs 3.5 mm, p = 0.007). The findings of an axial non-arborising superficial system (96.7% vs 0, p < 0.001), without connection to deep system perforators (38.1 vs 88.8%, p < 0.001) and a type I pedicle were also predictive (75 vs 64.2%, p = 0.22). These results show the importance of CTAs as a pre-operative study for the identification of risk factors for venous compromise, and their use should prompt a robust discussion of the risk of flap failure with patients, and contingency planning to augment venous drainage with the superficial system if required.
Q-Index Code CX
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
School of Medicine Publications
UQ Diamantina Institute Publications
 
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Created: Thu, 31 Mar 2016, 22:04:06 EST by Kristen Gibbons on behalf of School of Medicine