Extended deep inferior epigastric artery perforator flap for head and neck reconstruction: a clinical experience with 100 patients.

Abstract

The extended deep inferior epigastric perforator (DIEP) artery flap had been described in 1983. For head and neck reconstruction, we have been using a variation of this flap, namely a perforator free flap of the deep inferior epigastric system with a superolateral extension of the skin paddle. The purpose of this study was to present our 10-year experience in the performance of 102 soft tissue head and neck reconstructions with the extended DIEP flap in 100 patients. Depending on the reconstructive needs, we used the extended DIEP flap in 3 ways: as a cutaneous perforator flap (52.9%), as a chimeric perforator flap (6.9%), and as a myocutaneous perforator flap (40.2%). The overall flap survival rate was 97.1%. Three flaps (2.9%) totally necrosed. Partial flap loss occurred in 5.9% of the cases. The extended DIEP flap is reliable, has a safe vascular supply, and has a long pedicle. Its versatility makes it suitable for reconstruction of moderate to large head and neck reconstruction.