Clinical application of modified deep inferior epigastric perforator flap

Abstract

Objective To improve the techniques of harvesting the deep inferior epigastric perforator (DIEP) flap and broaden the clinical application of the flap. Methods A modified DIEP flap (or DIEP osteofasciocutaneous flap with iliac or rib) involving perforating vessels of the bilateral deep inferior epigastric vasculature with a muscle cuff was used to cover large defects of the extremities. There were 5 cases of defects of the forearm and 6 cases with defects of the hand and wrist. The areas of the defects were 10.0 cm × 5.0 cm to 45.0 cm × 20.0 cm. All flap transfers were done in the emergent setting. Results 10 of the 11 flaps survived completely while one flap survived with partial necrosis. Follow up ranged from 3 to 61 months. The flaps healed well. Function of the hand was satisfactory. There was no abdominal wall hernia at the donor sites. Conclusion The modified DIEP flap involving bilateral pedicles is the procedure of option for reconstruction of large defects. Key words: Surgical flaps; Wounds and injuries; Reconstructive surgical procedures