Strategies and methods of monitoring and rescue of DIEP flap in breast reconstruction (with video) / 中华内分泌外科杂志

ABSTRACT

Autologous tissue reconstruction accounts for a certain proportion in immediate or delayed breast reconstruction. Deep infra-epigastric perforator free flap has its significant advantages, gradually being widely promoted and applied in China. The success rate of DIEP surgery is generally over 95%. However, vessel crisis and flap necrosis are inevitable. Before surgery, personnel and equipment should be prepared and patients should be thoroughly evaluated. During the surgical process, it is necessary to follow certain programmed and standardized procedures. Meticulous manipulations through entire operation are the key to reduce the risk of vessel crisis. Standard of procedure for flap monitoring during and after surgery should be established, and strictly implemented. If vessel crisis occurs, timely and orderly organization, exploration, and rescue should be carried out. The surgical team should do their best to identify problems, and rescue the flap as much as possible. Ensuring the overall safety and reducing interference with subsequent adjuvant treatment for patients should be considered. Based on the author’s long-term and extensive clinical work experience, this paper shares and discusses the strategies and methods of monitoring and rescue of free flap in breast reconstruction.