Salvage of a DIEP flap using a retrograde flow anastomosis

Regarding the use of the serratus anterior muscle pedicle as recipient vessels in DIEP flap breast reconstruction

“…1 We feel that this pedicle may have value in a salvage scenario, as reported by Caulfield et al 4 However, we would only adopt it with caution based on these contrasting reports.…”

Salvage of SIEA flaps using the retrograde internal mammary system

“…This study was followed by hemodynamic evaluation of the proximal and distal IMA stumps, confirming the utility of the distal IMA in flap perfusion. Cauldfied et al 10 reported successful salvage of a thrombosed DIEP flap by performing a retrograde anastamosis with the distal serratus branch of the thoracodorsal vessel and it has also been described in the salvage of latissimus dorsi pedicled flaps. 13,14 Our group reported retrograde arterial and venous drainage in a double pedicle DIEP flap 15 and has recently studied the retrograde limb of the IMV and determined it to be a viable option as a recipient vein in DIEP breast reconstruction.…”

“…Recently, reverse flow anastamoses have been described as both a prevention and restoration technique following compromise of the original anastamosis. 10,11 While the concept of reverse flow anastamosis is not new, there is limited discussion of its use in breast reconstruction. Li et al 12 have described the use of the retrograde or distal ends of the internal mammary vessels in cases of free bipedicled TRAM flaps for unilateral breast reconstruction.…”

Salvage of a TRAM breast reconstruction flap using the retrograde internal mammary artery system

“…[ 1 ] Salvage techniques using the retrograde limb of the internal mammary vessels have been described following flap compromise of the original antegrade anastomosis. [ 2 3 ]…”