JPRAS Open (Mar 2020)

The use of venous anastomotic flow couplers to monitor buried free DIEP flap reconstructions following nipple-sparing mastectomy

  • S.L. Chadwick,
  • R. Khaw,
  • J. Duncan,
  • S.W. Wilson,
  • L. Highton,
  • S. O'Ceallaigh

Journal volume & issue
Vol. 23
pp. 50 – 54

Abstract

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Nipple sparing mastectomy with free tissue transfer for breast reconstruction offers excellent aesthetic outcomes but poses a challenge in monitoring the buried flap. Venous anastomotic flow couplers directly monitor buried flaps without the need for monitoring skin paddles. In a two year period we used the Synovis GEM™ flow coupler on 24 DIEP flaps. In our practice, flow couplers are effective in monitoring buried free flaps for breast reconstruction. The avoidance of a second procedure to remove a skin paddle improves patient experience and nullifies the additional flow coupler cost. One patient needed return to theatre when a Doppler wire became dislodged early in the series. There were no other issues with flap monitoring and no flap failures. We offer our tips to optimise flow coupler use. Keywords: Nipple-sparing, Mastectomy, Flow coupler, DIEP