A systematic review of the scientific evidence of venous supercharging in autologous breast reconstruction with abdominally based flaps.

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Hansson, Emma,1981Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för plastikkirurgi,Institute of Clinical Sciences, Department of Plastic Surgery (författare)

A systematic review of the scientific evidence of venous supercharging in autologous breast reconstruction with abdominally based flaps.

Artikel/kapitelEngelska2023

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2023

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LIBRIS-ID:oai:gup.ub.gu.se/330912
https://gup.ub.gu.se/publication/330912URI
https://doi.org/10.1186/s12957-023-03254-9DOI

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Språk:engelska

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Abdominally based free flaps are commonly used in breast reconstruction. A frequent complication is venous congestion, which might contribute to around 40% of flap failures. One way to deal with it is venous supercharging. The primary aim of this study was to investigate the scientific evidence for the effects of venous supercharging.A systematic literature search was conducted in PubMed, CINAHL, Embase, and Cochrane library. The included articles were critically appraised, and certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.Thirty-six studies were included. Most studies had serious study limitations and problems with directness. Three studies report 'routine' use of venous supercharging and performed it prophylactically in patients who did not have clinical signs of venous congestion. Seventeen studies report on flap complications, of which one is a randomised controlled trial demonstrating statistically significant lower complication rates in the intervention group. The overall certainty of evidence for the effect of a venous supercharging on flap complications, length of hospital stay and operative time, in patients without clinical signs of venous congestion, is very low (GRADE⊕⊕⊝⊝), and low on and surgical takebacks (GRADE⊕⊕⊝⊝). Twenty-one studies presented data on strategies and overall certainty of evidence for using radiological findings, preoperative measurements, and clinical risk factors to make decisions on venous supercharging is very low (GRADE⊕⊝⊝⊝).There is little scientific evidence for how to predict in which cases, without clinical signs of venous congestion, venous supercharging should be performed. The complication rate might be lower in patients in which a prophylactic venous anastomosis has been performed.PROSPERO (CRD42022353591).

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng

Biuppslag (personer, institutioner, konferenser, titlar ...)

Ramakrishnan, Venkat (författare)
Morgan, Mary (författare)
Göteborgs universitetInstitutionen för kliniska vetenskaper, Avdelningen för plastikkirurgi (creator_code:org_t)

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Ingår i:World journal of surgical oncology21:11477-7819

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Av författaren/redakt...: Hansson, Emma, 1 ...; Ramakrishnan, Ve ...; Morgan, Mary

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kirurgi

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Av lärosätet: Göteborgs universitet

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