Thinned Pedicle Deep Inferior Epigastric Perforator (DIEP) Flap for Scrotal Reconstruction

Abstract

The deep inferior epigastric artery perforator (DIEP) flap has been widely used for approximately 30 years as an effective method for breast reconstruction, defect repair, and perineal reconstruction. However, few literatures have reported on thinned pedicle DIEP flaps for scrotal reconstruction. The present study presents a series of reconstruction of the scrotum using thinned pedicle DIEP flaps. Five patients with large scrotal skin defects were admitted to our hospital from October 2010 to December 2015. Among these patients, three patients had testes and spermatic cord exposure after accidental injury, while two patients had testes exposure after machine extrusion. All of these patients were repaired using thinned pedicle DIEP flaps. During the 12–24-month follow up, one patient experienced a bulky flap, and a subsequent thinned flap was successfully made. The other four flaps were successfully transplanted with good esthetic and functional results. All donor sites were primarily closed; there was no functional disturbance, such as dysuria and abdominal hernia, and the sensation of these flaps partially recovered after 6 months. The thinned pedicle DIEP flap is robust, reliable, and resilient, and offers good-quality skin cover and cushion to the testes. This flap can be considered a good choice for scrotal reconstruction.