{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T01:55:47Z","timestamp":1789782947922,"version":"4.0.1"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T00:00:00Z","timestamp":1727913600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>With the rising popularity of the deep inferior epigastric perforator (DIEP) flap in breast reconstruction, use of the superficial inferior epigastric vein (SIEV) to augment venous outflow has been proposed as a strategy to prevent venous congestion, a complication positively associated with flap volume. This study evaluated the impact of routine SIEV venous augmentation on the risk of vascular complications or operative fat necrosis in the context of flap size and operating time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study compared complication rates of patients with SIEV\u2010augmented DIEP flaps to controls over a 3\u2010year period. Outcomes assessed included vascular complications, defined as venous congestion or compromise requiring take\u2010back, partial flap necrosis, total flap loss, as well as operative fat necrosis. Relative risk was modeled by Cox proportional hazard regression analysis. Sensitivity analysis was performed to assess for an interaction effect by flap mass.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study sample included 197 patients with 316 flaps. The mean mass of the SIEV\u2010augmented flaps was significantly greater than in the control group (832.9 vs. 653.9\u2009g;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0007). After adjustment for flap characteristics, patient demographic factors, and comorbidities, pooled risk of vascular complication and operative fat necrosis was found to be significantly lower in the SIEV\u2010augmented group compared to controls (hazard ratio\u2009=\u20090.33, 95% CI [0.11\u20131.00];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0489). Sensitivity analysis demonstrated no effect interaction by flap weight (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.5139).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Routine venous outflow augmentation via anastomosis of SIEV to the internal mammary vein perforator at the second intercostal space significantly reduced the risk of vascular complications and operative fat necrosis, regardless of flap weight. No significant increase in operative time was observed among cases in which augmentation was performed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/micr.31220","type":"journal-article","created":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T06:19:23Z","timestamp":1727936363000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Effect of Venous Augmentation on Complication Rates in Deep Inferior Epigastric Perforator Breast Reconstruction"],"prefix":"10.1002","volume":"44","author":[{"given":"Alexander","family":"Germann","sequence":"first","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery Louisiana State University Health Sciences Center  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Palines","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery Louisiana State University Health Sciences Center  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Doran","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Plastic Surgery Louisiana State University School of Medicine  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3428-7964","authenticated-orcid":false,"given":"Devin M.","family":"Melancon","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Plastic Surgery Louisiana State University School of Medicine  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo","family":"St. Hilaire","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery Louisiana State University Health Sciences Center  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Allen","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery Louisiana State University Health Sciences Center  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Stalder","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Plastic Surgery Stalder Plastic Surgery  New Orleans Louisiana 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