DIEP Flap for Head and Neck Reconstruction: An Underutilized Option!

Author:

Jaiswal Dushyant1ORCID,Borle Firoz2,Mathews Saumya1ORCID,Mantri Mayur1ORCID,Kumar Vineet1,Bindu Ameya1ORCID,Yadav Prabha34,Shankhdhar Vinay Kant1ORCID

Affiliation:

1. Plastic and Reconstructive Surgery, Homi Bhabha National Institute, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India

2. Siddharth Gupta Memorial cancer Hospital, Jawaharlal Nehru Medical College, Sawangi Meghe, Wardha, Maharashtra, India

3. Plastic and Reconstructive Surgery, Sir H.N. Reliance Foundation Hospital and Research Centre, Maharashtra, India

4. Department of Plastic and Reconstructive surgery, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India

Abstract

Abstract Background The deep inferior epigastric artery perforator (DIEP) flap is a workhorse flap for breast reconstruction. Its use for head and neck (HN) reconstruction is rare. Abdomen provides a donor site abundant in skin and subcutaneous tissue, amenable to primary closure; sizeable, robust, and consistent perforators and a long, sizeable pedicle for comfortable microvascular anastomosis. Its offers all the donor variables needed for HN reconstruction in abundance. Methods It is a quasiexperimental design study. DIEP flap use for HN reconstruction in our series was opportunistic, that is, when donor site matched the defect. Cases that had very thick thighs and lesser bulk in abdomen and cases that had very thin thighs but much more bulk in abdomen were considered for reconstruction using DIEP flap. Results The DIEP flap was done in 11 cases for HN reconstruction. There were two re-explorations during postoperative period: one flap loss and another had partial necrosis. Conclusion Abdomen is an excellent donor site option for HN reconstruction in selected cases, especially when harvested as a perforator flap.

Publisher

Georg Thieme Verlag KG

Subject

Surgery

Reference12 articles.

1. Breast reconstruction after surgery for breast cancer;P G Cordeiro;N Engl J Med,2008

2. The evolution of perforator flap breast reconstruction: twenty years after the first DIEP flap;C Healy;J Reconstr Microsurg,2014

3. Donor site scar preference in patients requiring free flap reconstruction;G J McLeod;Plast Surg (Oakv),2020

4. Inferior epigastric artery skin flaps without rectus abdominis muscle;I Koshima;Br J Plast Surg,1989

5. Deep inferior epigastric perforator flap for breast reconstruction;R J Allen;Ann Plast Surg,1994

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