Clinical Outcomes of Single versus Double Venous Anastomoses in DIEP Flap Breast Reconstruction: A Single-Center Experience of 11 Cases (2022–2025)
4th International Microsurgery Meeting Izmir, İzmir, Turkey, 26 - 28 September 2025, pp.18-21, (Full Text)
- Publication Type: Conference Paper / Full Text
- City: İzmir
- Country: Turkey
- Page Numbers: pp.18-21
- Bursa Uludag University Affiliated: Yes
Abstract
This study aimed to evaluate and compare the outcomes of single- versus double-vein anastomoses in DIEP flap breast reconstruction, focusing on the impact of using veins from the same or different venous systems. Between 2022 and 2025, a total of 11 DIEP flap breast reconstructions were performed after mastectomy at a single center. Patients were divided into single-vein (n=5) and double-vein (n=6) groups. In the double-vein group, four cases involved same-system anastomoses (deep inferior epigastric veins), and two cases involved different-system anastomoses (deep inferior epigastric vein plus superficial inferior epigastric vein). In the single-vein group, four flaps survived completely, and one resulted in total loss. In the double-vein group, two partial necroses occurred in same-system anastomoses, while all different-system anastomoses were viable. These findings align with recent literature, suggesting that additional venous drainage through the superficial system (superdrainage) can improve flap viability by reducing venous congestion. The DIEP flap remains a reliable option for autologous breast reconstruction, and dual venous anastomosis—particularly when involving different venous systems—represents an effective strategy to optimize venous outflow. However, further studies with larger patient series are necessary to define the optimal recipient vein selection and evaluate long-term results.