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Comparing Minimally Invasive and Conventional Approaches to DIEP Flap Harvest: A Matched-Pair Analysis from a
Florian Bucher1, Martynas Tamulevicius2, Nadjib Dastagir2
1Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany. bucher.florian@mh-hannover.de.
Aesthetic Plastic Surgery
|August 11, 2025
Summary
A new short fasciotomy technique for deep inferior epigastric perforator (DIEP) flap harvest significantly reduces donor site morbidity. This minimally invasive approach leads to faster patient mobility and shorter hospital stays compared to conventional methods.
Area of Science:
- Microsurgery
- Plastic Surgery
- Reconstructive Surgery
Background:
- Donor site morbidity is a concern in autologous deep inferior epigastric perforator (DIEP) flap harvesting.
- Minimally invasive techniques are sought to improve outcomes for patients undergoing DIEP flap reconstruction.
Purpose of the Study:
- To demonstrate a short fasciotomy technique for DIEP flap harvest.
- To quantify outcomes, analgesia requirements, and time to mobility compared to the conventional approach.
Main Methods:
- Retrospective, single-center study of 22 patients undergoing unilateral breast reconstruction with DIEP flaps.
- Patients undergoing minimally invasive DIEP flap harvest were matched with those receiving conventional harvest.
Main Results:
- Minimally invasive DIEP flap harvest resulted in a significantly shorter fasciotomy length (2.79 cm vs. 9.72 cm).
- Faster time to first mobility (1.18 days vs. 2.09 days) and reduced opioid requirements (18 mg vs. 42 mg) were observed.
- Patients in the minimally invasive group had shorter hospital stays (5.2 days) with no flap loss.
Conclusions:
- Minimally invasive DIEP flap harvesting with short fasciotomies is safe and effective.
- This technique minimizes functional donor site morbidity.
- It offers improved patient outcomes, including faster mobilization and reduced hospital stay.
