Use of a pre-expanded "propeller" deep inferior epigastric perforator (DIEP) flap for a large abdominal wall defect

Large abdominal wall soft tissue defects are traditionally reconstructed using loco-regional flaps and/or tissue expanders. Pedicled perforator flaps offer similar tissue coverage with minimal donor site morbidity and do not require microsurgical skills. The deep inferior epigastric perforator (DIEP) flap has become increasingly popular for breast reconstruction and offers abundant soft tissue while permitting primary donor site closure. To minimize operative sessions, recovery time, donor site morbidity, and avoid microsurgery, we combined tissue expansion with a "propeller" flap design and report this first case of a pre-expanded pedicled perforator flap based on the DIEP to address a large abdominal wall defect due to a burn injury.