Ischemia Time and Vascular Complications Following DIEP Flap Breast Reconstruction

DIEP flap is nowadays the gold standard in breast reconstruction. As a microsurgical flap, it is subjected to ischemia - reperfusion injury and no reflow phenomenon, both of which are influenced by high ischemia times. In this work we retrospectively reviewed the rates of microvascular complications and flap loss according to ischemia times in patients submitted to immediate DIEP flap breast reconstruction. The overall median of ischemia time was calculated and patients grouped as A (below median) and B (above median). Age, body mass index, history of smoking, hypertension, abdominal scars, preoperative chemo and/or radiotherapy and mean time of ischemia was determined in each group and compared. Statistical analysis revealed no differences among the different variables studied as well as in the rates of microvascular complications. Altogether, our findings show that ischemia time is irrelevant for flap survival in immediate DIEP flap breast reconstruction, at least until 134 min.