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DIEP Flap for Head and Neck Reconstruction: An Underutilized Option!
Dushyant Jaiswal1, Firoz Borle2, Saumya Mathews1
1Plastic and Reconstructive Surgery, Homi Bhabha National Institute, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India.
Summary
The deep inferior epigastric artery perforator (DIEP) flap, commonly used in breast reconstruction, can be a valuable option for head and neck reconstruction in select cases. The abdomen offers abundant tissue and reliable perforators for successful outcomes.
Area of Science:
- Microsurgery
- Plastic Surgery
- Reconstructive Surgery
Background:
- The deep inferior epigastric artery perforator (DIEP) flap is a standard for breast reconstruction.
- Its application in head and neck (HN) reconstruction is infrequent.
- The abdomen offers a rich donor site with ample tissue, reliable perforators, and a long pedicle suitable for microvascular anastomosis.
Purpose of the Study:
- To evaluate the utility of the DIEP flap for head and neck reconstruction.
- To explore the abdomen as a donor site for HN reconstruction using DIEP flaps.
Main Methods:
- A quasiexperimental study design was employed.
- DIEP flaps were opportunistically used for HN reconstruction when the abdominal donor site matched the defect.
- Patient selection considered thigh and abdominal tissue bulk.
Main Results:
- The DIEP flap was utilized in 11 cases for HN reconstruction.
- Two re-explorations were necessary postoperatively.
- Outcomes included one complete flap loss and one partial flap necrosis.
Conclusions:
- The abdomen is a viable donor site for HN reconstruction in carefully selected patients, particularly when utilizing perforator flaps like the DIEP flap.
- This technique offers a valuable reconstructive option for specific HN defects.
