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

doi:10.1016/j.jpra.2019.09.002

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

JPRAS Open. 2019 Nov 4:23:50-54. doi: 10.1016/j.jpra.2019.09.002. eCollection 2020 Mar.

Authors

S L Chadwick¹, R Khaw¹, J Duncan¹, S W Wilson¹, L Highton¹, S O'Ceallaigh¹

Affiliation

¹ Department of Plastic Surgery, Wythenshawe Hospital, Manchester University NHS Foundation Trust, United Kingdom.

Abstract

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: DIEP; Flow coupler; Mastectomy; Nipple-sparing.

Publication types

Case Reports