Abstract
In this study, we evaluated the peri-operative abdominal drain volumes and length of hospital admission between our superficial inferior epigastric artery (SIEA) and deep inferior epigastric artery perforator (DIEP) patients to determine whether SIEA flaps were associated with increased post-operative abdominal drainage and length of hospital stay. We studied consecutive patients who had breast reconstruction using either a free SIEA (seven) or DIEP (28) flaps. All patients had abdominal drains inserted, and cumulative drainage measurements were taken every 24 h. Data on patient's age, BMI, length of hospital stay, smoking history, and abdominal fluid drainage were collected. Statistical analyses were performed using a t test (Mann–Whitney). A statistically significant difference (P = 0.029) was observed in the total abdominal drainage between the two groups. The mean drainage volume in the SIEA group was 2,248 ml and 531 ml in the DIEP group. No association was observed between smoking and drainage volume in the DIEP group. Similarly, obesity did not appear to influence drainage volumes in either the SIEA or the DIEP groups. The average length of stay for the SIEA group was 10.4 days and 9.1 days in the DIEP group, although this was not statistically significant (P = 0.351). While abdominal wall morbidity is reduced in patients undergoing an SIEA flap for breast reconstruction, in our series, we found that the SIEA flap was associated with a significant increase in abdominal drain volume relative to the DIEP flap, which translated to an extra day in hospital.
Similar content being viewed by others
References
Holmstrom H (1979) The free abdominoplasty flap and its use in breast reconstruction. Scand J Plast Reconstr Surg 13:423–427
Hartrampf C, Scheflan M, Black P (1982) Breast reconstruction with a transverse abdominal island flap. Plast Reconstr Surg 69:216–224
Allen R, Treece P (1994) Deep inferior epigastric perforator flap for breast reconstruction. Ann Plast Surg 32:32–38
Taylor G, Daniel R (1975) The anatomy of several free flap donor sites. Plast Reconstr Surg 56:243–253
Grotting J (1991) The free abdominoplasty flap for immediate breast reconstruction. Ann Plast Surg 27:351–354
Holm C, Mayer M, Hofter E, Raab N, Ninkovic M (2008) Interindividual variability of the SIEA angiosome: effects on operative strategy in breast reconstruction. Plast Reconstr Surg 122(6):1612–1620
Wu Liza C, Anureet B, Chang David W, Chevray Pierre M (2008) Comparison of donor-site morbidity of SIEA, DIEP, and muscle-sparing TRAM flaps for breast reconstruction. Plast Reconstr Surg 122(3):710–716
Chevray Pierre M (2004) Breast reconstruction with superficial inferior epigastric artery flaps: a prospective comparison with TRAM and DIEP flaps. Plast Reconstr Surg 114(5):1077–1083
Allen R, Heitland A (2002) Superficial inferior epigastric artery flap for breast reconstruction. Semin Plast Surg 16(1):35–43
Granzow JW, Levine JL, Chiu ES, Allen R (2006) Breast reconstruction with the deep inferior epigastic perforator flap: history and an update on current technique. J Plastic Reconstr Aesthetic Surg 59:571–579
Blondeel PN, Vandetstraeten GG, Monstrey SJ et al (1997) The donor site morbidity for DIEP flaps and free TRAM flaps for breast reconstruction. Br J Plast Surg 50:322–330
Flutter CM, Webster MHC, Hagen S, Mitchel SLA (2000) A restrospective comparison of abdmoninal muscle strength following breast reconstruction with a free TRAM or DIEP flap. Br J Plast Surg 53:578–583
Spiegel AJ, Khan Farah N (2007) An intraoperative algorithm for use of the SIEA flap for breast reconstruction. Plast Reconstr Surg 120(6):1450–1459
Allen RJ, Treece P (1994) Deep inferior epigastric perforator flap for breast reconstruction. Ann Plast Surg 8:32–38
Arnez ZM, Khan U, Pogorelec D, Planinsek F (1999) Rational selection of flaps from the abdomen in breast reconstruction to reduce donor site morbidity. Br J Plast Surg 52:351–354
Nahabedian M, Tsangaris T, Momen B (2005) Breast reconstruction with the DIEP flap or the muscle-sparing (MS-2) free TRAM flap: is there a difference? Plast Reconstr Surg 115:436–444
Blondeel P (1999) One hundred free DIEP flap breast reconstructions: a personal experience. Br J Plast Surg 52:104–111
Conflict of interest
None
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Moradi, P., Durrant, C., Glass, G.E. et al. SIEA flap leads to an increase in abdominal seroma rates compared to DIEP flap for breast reconstruction. Eur J Plast Surg 34, 87–91 (2011). https://doi.org/10.1007/s00238-010-0470-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00238-010-0470-0