Bilateral, Bipedicled DIEP Flap for Staged Reconstruction of Cranial Deformity

The deep inferior epigastric perforator (DIEP) adipocutaneous flap is a versatile flap that has been most popularly used in breast reconstruction. However, it has been applied to many other anatomic areas and circumstances that require free-tissue transfer. We present a case report of the use of the DIEP flap for the reconstruction of severe craniomaxillofacial deformity complicated by indolent infection in a gentleman with infected hardware and methyl methacrylate overlay used in previous repair of traumatic injuries suffered from a motor vehicle collision. The reconstruction was done in a staged, two-step fashion that allowed for adequate infection eradication and treatment using a bilateral, bipedicled DIEP flap for tissue coverage and intravenous antibiotics before the delayed insertion of a polyetheretherketone cranioplasty for reconstruction of the cranial defect.