A pedicled deep inferior epigastric artery perforator flap for abdominal wall and inguinal reconstruction

A total of six cases underwent reconstruction of massive abdominal wall and inguinal defects. All of the defects were successfully reconstructed by a pedicled deep inferior epigastric artery perforator flap (DIEP flap) except for one case that developed a partial necrosis in zone 2. Three DIEP flaps were used for dehisced abdominal wounds, two for exposed femoral vessels accompanied by massive skin defects and one for a dehisced wound following phallic reconstruction using a thin anterolateral thigh flap. The DIEP flap that was first described by Koshima and Soeda in 1989 and has many advantages compared with conventional rectus abdominis musculocutaneous flaps. The advantages of the DIEP flap are a muscle-sparing dissection that results in minimum donor site morbidity, a longer vascular pedicle obtained by skeletonizing the intramuscular portion of the perforator and a uniform thickness of the flap. Therefore, the DIEP flap is becoming common in breast reconstruction on behalf of the conventional transverse rectus abdominis musculocutaneous flap. Although the DIEP flap has not generally been accepted due to technical difficulties, we consider that this flap is quite useful in reconstruction of massive defects in the abdominal and inguinal region.