The versatile deep inferior epigastric (inferior rectus abdominis) flap

The deep inferior epigastric vascular system nourishes a vast area of the anterior abdominal wall and offers a versatile variety of tissue combinations to the reconstructive surgeon for local or free flap transfer. Its supply to and beyond the rectus abdominis muscle provides the basis for flap design. Eighteen cases are presented to illustrate various muscle, myocutaneous and myosubcutaneous flaps that have been used to date to repair defects in the extremities and in the head and neck. The ease of dissection, coupled with the large calibre and length of the vascular stem, are key factors which combine to offer a speedy and a reliable technique. The donor site scar has been improved by the use of a suprapubic transverse incision to dissect the pedicle and this exposure provides access to the iliac crest for bone grafts where indicated. Time will evaluate this technique and further designs and modifications will undoubtedly be forthcoming. Meanwhile the initial results have been most promising.