The Utilization of a More Cosmetically Acceptable Deep Inferior Epigastric Artery Perforator (DIEAP) Flap For Head and Neck Soft Tissue Defects Reconstruction
Abstract: Various free flaps have been utilized for the reconstruction of the maxillofacial defects.The deep inferior epigastric perforator flap (DIEP) is utilized as a potential source of soft tissue for head and neck reconstruction. In addition to its ability to provide a large skin paddle, bulky adipose tissue, it has the advantage of adding improvement in the cosmetic outcome at the donor site with minimal morbidity. The aim of this retrospective chart review study is to share our experience with this reconstructive technique in head and neck surgery.
PATIENTS AND METHODS:The present study was a retrospective chart review for patients treated at the Oral and Maxillofacial Surgery Department at the University of Miami Miller School of Medicine, during a one-year period between 2011 and 2012. We identified five patients, (1 man, 3 women), the age range from (28 to 65), and the defect sizes ranged from (20cm2 to 600cm2). Surgical defects treated were the result from a variety of different pathologies, including temporal meningioma with cranial bone osteomyelitis, Adenoid cystic carcinoma, neck fibrosis and scar excision, and a gun shut wound to the face with multiple infections. All cases were reconstructed with a deep inferior epigastric artery perforator (DIEAP) flap. The flap was harvested following the same principles as for breast reconstruction.
RESULTS:We report a 100% success rate related to primary flap survival, No major complication of the donor site was observed. However, one patient had minor abdominal wound dehiscence that was treated with local wound care with the need for revisional surgery.Patient-reported satisfaction at 6 months was excellent in all cases. All abdominal incisions healed with good cosmetic results compared to the vertical incision scar resulted when vertical or oblique incisions were used for harvesting.
CONCUSION:We conclude that in select cases, the DIEAP flap is a reliable alternative for head and neck soft tissue defects. It provides a large volume of soft tissue for transfer with predictable, good functional result, and excellent donor site cosmesis, with low morbidity.
References:
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3. Zhang B., De-Zhi L., Zhen-Gang X., Tang P et all : Deep Inferior Epigastric Artery Perforator Free Flaps in Head and Neck Reconstruction