Successful Deep Inferior Epigastric Perforator Flap Harvest despite Preoperative Therapeutic Subcutaneous Heparin Administration into the Abdominal Pannus
Abdominal free flaps for microsurgical breast reconstruction are most commonly harvested based on the deep inferior epigastric vessels that supply skin and fat via perforators through the rectus muscle and sheath. Intact perforator anatomy and connections are vital for subsequent optimal flap perfus...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Case Reports in Surgery |
| Online Access: | http://dx.doi.org/10.1155/2016/9168154 |
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| author | Joseph W. Duncumb Kana Miyagi Parto Forouhi Charles M. Malata |
| author_facet | Joseph W. Duncumb Kana Miyagi Parto Forouhi Charles M. Malata |
| author_sort | Joseph W. Duncumb |
| collection | DOAJ |
| description | Abdominal free flaps for microsurgical breast reconstruction are most commonly harvested based on the deep inferior epigastric vessels that supply skin and fat via perforators through the rectus muscle and sheath. Intact perforator anatomy and connections are vital for subsequent optimal flap perfusion and avoidance of necrosis, be it partial or total. The intraflap vessels are delicate and easily damaged and it is generally advised that patients should avoid heparin injection into the abdominal pannus preoperatively as this may compromise the vascular perforators through direct needle laceration, pressure from bruising, haematoma formation, or perforator thrombosis secondary to external compression. We report three cases of successful deep inferior epigastric perforator (DIEP) flap harvest despite patients injecting therapeutic doses of low molecular weight heparin into their abdomens for thrombosed central venous lines (portacaths™) used for administering primary chemotherapy in breast cancer. |
| format | Article |
| id | doaj-art-1759da4aa9fb414d977bc6b66c048633 |
| institution | Kabale University |
| issn | 2090-6900 2090-6919 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Surgery |
| spelling | doaj-art-1759da4aa9fb414d977bc6b66c0486332025-02-03T01:08:54ZengWileyCase Reports in Surgery2090-69002090-69192016-01-01201610.1155/2016/91681549168154Successful Deep Inferior Epigastric Perforator Flap Harvest despite Preoperative Therapeutic Subcutaneous Heparin Administration into the Abdominal PannusJoseph W. Duncumb0Kana Miyagi1Parto Forouhi2Charles M. Malata3School of Clinical Medicine, University of Cambridge, Cambridge CB2 0SP, UKPlastic & Reconstructive Surgery Department, Addenbrooke’s University Hospital, Cambridge CB2 0QQ, UKCambridge Breast Unit, Addenbrooke’s University Hospital, Cambridge CB2 0QQ, UKPlastic & Reconstructive Surgery Department, Addenbrooke’s University Hospital, Cambridge CB2 0QQ, UKAbdominal free flaps for microsurgical breast reconstruction are most commonly harvested based on the deep inferior epigastric vessels that supply skin and fat via perforators through the rectus muscle and sheath. Intact perforator anatomy and connections are vital for subsequent optimal flap perfusion and avoidance of necrosis, be it partial or total. The intraflap vessels are delicate and easily damaged and it is generally advised that patients should avoid heparin injection into the abdominal pannus preoperatively as this may compromise the vascular perforators through direct needle laceration, pressure from bruising, haematoma formation, or perforator thrombosis secondary to external compression. We report three cases of successful deep inferior epigastric perforator (DIEP) flap harvest despite patients injecting therapeutic doses of low molecular weight heparin into their abdomens for thrombosed central venous lines (portacaths™) used for administering primary chemotherapy in breast cancer.http://dx.doi.org/10.1155/2016/9168154 |
| spellingShingle | Joseph W. Duncumb Kana Miyagi Parto Forouhi Charles M. Malata Successful Deep Inferior Epigastric Perforator Flap Harvest despite Preoperative Therapeutic Subcutaneous Heparin Administration into the Abdominal Pannus Case Reports in Surgery |
| title | Successful Deep Inferior Epigastric Perforator Flap Harvest despite Preoperative Therapeutic Subcutaneous Heparin Administration into the Abdominal Pannus |
| title_full | Successful Deep Inferior Epigastric Perforator Flap Harvest despite Preoperative Therapeutic Subcutaneous Heparin Administration into the Abdominal Pannus |
| title_fullStr | Successful Deep Inferior Epigastric Perforator Flap Harvest despite Preoperative Therapeutic Subcutaneous Heparin Administration into the Abdominal Pannus |
| title_full_unstemmed | Successful Deep Inferior Epigastric Perforator Flap Harvest despite Preoperative Therapeutic Subcutaneous Heparin Administration into the Abdominal Pannus |
| title_short | Successful Deep Inferior Epigastric Perforator Flap Harvest despite Preoperative Therapeutic Subcutaneous Heparin Administration into the Abdominal Pannus |
| title_sort | successful deep inferior epigastric perforator flap harvest despite preoperative therapeutic subcutaneous heparin administration into the abdominal pannus |
| url | http://dx.doi.org/10.1155/2016/9168154 |
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