ePlasty: Vol. 19
Successful Salvage of Delayed Venous Congestion After DIEP Flap Breast Reconstruction
Kristopher Katira, MD,a Samita Goyal, MD,b Chelsea Venditto, MD,b John A. LoGiudice, MD,b and Erin L. Doren, MDb

aDepartment of Plastic Surgery, Ochsner Health System, New Orleans, La; and bDepartment of Plastic Surgery, Medical College of Wisconsin, Milwaukee

Correspondence: edoren@mcw.edu
Key words: DIEP flap, microvascular flap compromise, microsurgery, venous congestion, breast reconstruction

Objective: Failure rates of microvascular autologous breast reconstruction are reportedly low. When failure of the microvascular anastomoses does occur, it is most likely to be salvaged if detected early. Flap compromise or venous congestion occurring several weeks later is uncommon and with significantly lower salvage rates. Methods: We present a unique case of delayed venous congestion of a single-perforator deep inferior epigastric perforator flap breast reconstruction in which the usual pedicle thrombosis was not identified. Presentation of the flap compromise occurred 72 hours postoperatively and again in the delayed setting 5 weeks after surgery, from suspected compression at the perforator level. Resul .......