A New Technique of Vaginal Reconstruction with the Deep Inferior Epigastric Perforator Flap: A Preliminary Report

Wang, Xiancheng; Qiao, Qun; Burd, Andrew; Liu, Zhifei; Zhao, Ren; Song, Kexin; Feng, Rui; Zeng, Ang; Zhao, Yuming

doi:10.1097/01.prs.0000259076.16918.fa

Cited by 49 publications

(35 citation statements)

References 19 publications

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“…The application of this flap in vaginal reconstruction was introduced in 2007. 11,12 Bilateral paraumbilical perforators arising from the lateral branch of the deep inferior epigastric artery are generally located into a distance of 8 to 10 cm from the umbilicus. The skin island of the flap is centered on the perforators and is drawn appropriately to the reconstructive needs; particularly, it could be oriented either vertically or transversally.…”

Section: Pedicle Deep Inferior Epigastric Perforator Flapmentioning

confidence: 99%

Vulvar Reconstruction by Perforator Flaps: Algorithm for Flap Choice Based on the Topography of the Defect

Negosanti

Sgarzani²,

Fabbri³

et al. 2015

Int J Gynecol Cancer

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We propose an easy classification of acquired vulvar defects separating the ones consequent only to the vulvar resection, with preservation of vagina (type I), by the wider defects after vaginal and vulvar resection (type II); type I can be subclassified into defects consequent to half-vulvar resection (type IA) or to total vulvar resection (type IB). Type I defects (IA and IB) can be reconstructed with monolateral or bilateral LPF; in type II resections, we have a great wound that required more tissue to fill the pelvic dead space, so we prefer pedicle DIEP flap.

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Section: Pedicle Deep Inferior Epigastric Perforator Flapmentioning

confidence: 99%

Vulvar Reconstruction by Perforator Flaps: Algorithm for Flap Choice Based on the Topography of the Defect

Negosanti

Sgarzani²,

Fabbri³

et al. 2015

Int J Gynecol Cancer

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“…large DIEP flaps have been used for reconstruction of the vagina, chest wall, inguinal region, scrotum, and lower extremities. [3][4][5]17,18 If a very large free DIEP flap is harvested, it is advisable to supercharge the arterial input by an additional anastomosis with the ipsilateral or contralateral superficial inferior epigastric artery or the inclusion of contralateral deep inferior epigastric vessels to the flap. 19 These maneuvers require extra microsurgery and expense.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5] Like the transverse rectus abdominis flap (TRAM flap), the vascularity of the DIEP flap, especially in zone 4, is problematic in high-risk patients (such as obese patients and smokers) and when the flap is large. 6,7 To increase the vascularity of the TRAM flap, surgical and vascular delay methods and microvascular augmentation methods have been described.…”

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confidence: 99%

Comparison of Two Different Vascular Delay Methods in a Rat Cranial Epigastric Perforator Flap Model

Seyhan¹,

Deniz²,

Borman³

et al. 2010

Annals of Plastic Surgery

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The effectiveness of vascular delay in transverse rectus abdominis muscle flaps has been demonstrated in many studies. In deep inferior epigastric perforator flaps, however, the effectiveness of ligation of deep versus superficial epigastric vessels in producing delay is unclear. Using a rat model, we compared ligation of deep and superficial vessels with each other and with a (nondelayed) control group (n = 10). One vascular delay group (n = 10) had ligation of the contralateral cranial epigastric vessels (homolog to the human deep inferior epigastric vessels); the other (n = 10) had ligation of contralateral superficial inferior epigastric vessels. One week later, cranial epigastric perforator flap elevation was performed. Both vascular techniques were effective in producing delay, and there was no statistically significant difference between the 2 groups. Ligation of superficial inferior epigastric vessels, deep inferior epigastric vessels, or both, at least 1 week prior to the deep inferior epigastric perforator flap elevation may increase the usable skin paddle area in humans.

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“…[13][14][15][16] As a pedicled flap, DIEP flap has been used in the repair of defects in the perineal and inguinal regions, as well as for vaginal reconstruction. [17][18][19][20] In summary, DIEP flap is representative of perforator flaps because it has the advantages of minimal donor site morbidity, direct closure of the donor site, long and constant vascular pedicle, and unchanged position of the patient during surgery. It is used widely in the field of plastic and reconstructive surgery.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of Cicatricial Microstomia and Lower Facial Deformity by Windowed, Bipedicled Deep Inferior Epigastric Perforator Flap

Jin

Teng

Zhao

et al. 2009

Annals of Plastic Surgery

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We performed simultaneous facial scar repair and oral aperture open with a windowed, bilateral, bipedicled deep inferior epigastric perforator flap (DIEP flap) in a 20-year-old male patient who had suffered from severe postburn scar of the face and neck in association with serious cicatricial microstomia. DIEP flap is a typical perforator flap that has less donor site morbidity because of a minimal sacrifice of muscles. Since bipedicled DIEP flap can provide the largest skin territory in the lower abdominal wall and ensure a sufficient blood supply to zone IV, it is very suitable for the repair of massive defects of the face and neck. From our challenging case, we learned that bilateral, bipedicled DIEP flap is an excellent option for the repair of large faciocervical defects. Bilateral, bipedicled DIEP flap, which can produce an excellent esthetic and functional outcome, has reliable blood perfusion, provides soft and pliable tissue, and causes the minimal donor-site morbidity.

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A New Technique of Vaginal Reconstruction with the Deep Inferior Epigastric Perforator Flap: A Preliminary Report

Abstract: This series demonstrates that a new vagina can be created from the pedicled DIEP flap and that the reconstruction is reliable, with low donor-site morbidity. The major disadvantage of this technique is the conspicuous abdominal scar.

Cited by 49 publications

References 19 publications

Vulvar Reconstruction by Perforator Flaps: Algorithm for Flap Choice Based on the Topography of the Defect

Vulvar Reconstruction by Perforator Flaps: Algorithm for Flap Choice Based on the Topography of the Defect

Comparison of Two Different Vascular Delay Methods in a Rat Cranial Epigastric Perforator Flap Model

Reconstruction of Cicatricial Microstomia and Lower Facial Deformity by Windowed, Bipedicled Deep Inferior Epigastric Perforator Flap

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