An Anatomic Study of the Venous Drainage of the Transverse Rectus Abdominis Musculocutaneous Flap

Costa, Maria Aparecida Carramenha e; Carriquiry, Carlos; Vásconez, Luis O.; Grotting, James C.; Herrera, Raul H.; Windle, Brian H.

doi:10.1097/00006534-198702000-00011

Cited by 18 publications

(17 citation statements)

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“…Anatomical studies by Carramenha e Costa et al (1987) and Taylor et al (1990) have indeed described deep and superficial venous systems that mirror the pattern of arterial supply (Carramenha e Costa et al, 1987;Taylor, 1987;Taylor et al, 1990). These studies have described a superficial system of veins that communicate in a subdermal plexus as well as axial veins that traverse the superficial tissues as venae comitantes of the SIEA, SCIA, and SEPA.…”

Section: Venous Drainage Of the Anterior Abdominal Wallmentioning

confidence: 97%

Reviewing the vascular supply of the anterior abdominal wall: Redefining anatomy for increasingly refined surgery

2008

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The abdominal wall integument is becoming the standard donor tissue for postmastectomy breast reconstruction, with its vascular supply of key importance to the reconstructive surgeon. Refinements in tissue transfer, from pedicled to free flaps and musculocutaneous to perforator flaps, have required increasing understanding of finer levels of this vascular anatomy. The widespread utilization of the deep inferior epigastric artery (DIEA) perforator flap, particularly for breast reconstruction, has rekindled clinical interest in further levels of anatomical detail, in particular the location and course of the musculocutaneous perforators of the DIEA. Advances in operative techniques, and anatomical and imaging technologies, have facilitated an increase in this understanding. The current review comprises an appraisal of both the anatomical and clinical literature, with a view to highlighting the key anatomical features of the abdominal wall vasculature as related to reconstructive flaps.

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Section: Venous Drainage Of the Anterior Abdominal Wallmentioning

confidence: 97%

Reviewing the vascular supply of the anterior abdominal wall: Redefining anatomy for increasingly refined surgery

2008

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“…A system of choke vessels exists between the superficial inferior epigastric vein and the deep inferior epigastric system; however, certain variations in anatomy may exist. [8] Venous branches crossing the midline have been found to be absent in 36% of cases [4,14]. This paucity of crossing branches explains why survival of Zone IVof the flap can be quite unpredictable.…”

Section: Discussionmentioning

confidence: 99%

Double Venous System Drainage in Deep Inferior Epigastric Artery Perforator Flap Breast Reconstruction

Boutros¹,

Martínez²

2016

Breast Reconstruction

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“…As presented by Carramenha e Costa et al, the largest vein draining the transverse infraumbilical skin paddle is the superficial inferior epigastric vein (SIEV), suggesting that venous drainage normally takes place preferentially through the superficial venous system. 8 However, subsequent to raising a DIEP flap venous drainage is redirected through smaller perforating veins ultimately draining the flap via the DIEV. Although the artery is typically large enough to supply the flap, these concomitant veins can occasionally be too small to sufficiently drain the entire flap.…”

Section: Discussionmentioning

confidence: 99%

A case of intraoperative venous congestion of the entire DIEP‐flap—A novel salvage technique and review of the literature

Momeni

Lee

2010

Microsurgery

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The deep inferior epigastric perforator (DIEP) flap is gaining popularity for autologous breast reconstruction as it reportedly reduces abdominal donor site morbidity when compared with the transverse rectus abdominis musculocutaneous (TRAM) flap. Disadvantages include greater technical difficulties during flap harvest and a greater incidence of vascular compromise. A well-known and feared complication is venous congestion which requires immediate intervention. We present a novel salvage technique in a case of total flap venous congestion in the setting of absent drainage via the deep inferior epigastric vein (DIEV). Utilizing the superficial venous system via the superficial inferior epigastric vein (SIEV) and using the DIEV as a venous interposition graft resulted in successful salvage of the DIEP flap.

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An Anatomic Study of the Venous Drainage of the Transverse Rectus Abdominis Musculocutaneous Flap

Cited by 18 publications

References 0 publications

Reviewing the vascular supply of the anterior abdominal wall: Redefining anatomy for increasingly refined surgery

Reviewing the vascular supply of the anterior abdominal wall: Redefining anatomy for increasingly refined surgery

Double Venous System Drainage in Deep Inferior Epigastric Artery Perforator Flap Breast Reconstruction

A case of intraoperative venous congestion of the entire DIEP‐flap—A novel salvage technique and review of the literature

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