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The versatile DIEP flap: its use in lower extremity reconstruction

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Presentation on theme: "The versatile DIEP flap: its use in lower extremity reconstruction"— Presentation transcript:

1 The versatile DIEP flap: its use in lower extremity reconstruction
Koenraad Van Landuyt, Phillip Blondeel, Moustapha Hamdi, Patrick Tonnard, Alex Verpaele, Stanislas Monstrey  British Journal of Plastic Surgery  Volume 58, Issue 1, Pages 2-13 (January 2005) DOI: /j.bjps

2 Figure 1 (A) The DIEP flap harvested with both deep inferior epigastric pedicles, one superficial epigastric pedicle, the superficial epigastric vein, and a lateral pedicle coming from the circumflex. (B) The contralateral deep inferior epigastric pedicle anastomosed end-to-end onto the continuation of the ipsilateral deep inferior epigastric pedicle after the perforator has branched off. (C) Typical donor-site scar. (D) Good perforator, both one artery and two veins visible (5-year-old girl). (E) Typical dissection picture, showing the perforator, the deep inferior epigastric, and the motor branches to be saved. British Journal of Plastic Surgery  , 2-13DOI: ( /j.bjps )

3 Figure 2 Case 1. (A) Aspect of the right foot at admission. (B) Aspect of the left leg at admission. (C) The obliquely cut DIEP flap. (D,E) The 3 year postoperative. Result, after liposculpture of the flaps. British Journal of Plastic Surgery  , 2-13DOI: ( /j.bjps )

4 Figure 3 Case 2. (A) Unstable scar of an upper leg amputation stump. (B) 1 year postoperative result after application of a DIEP flap. (C) The patient wearing his prosthesis. British Journal of Plastic Surgery  , 2-13DOI: ( /j.bjps )

5 Figure 4 Case 3. (A) Peroperative aspect of one of the flow-through anastomoses, arterial and venous. (B) Immediate postoperative. Angiography showing the interposition of both deep inferior epigastric pedicles and the perforators. British Journal of Plastic Surgery  , 2-13DOI: ( /j.bjps )

6 Figure 5 Case 4. Composite picture of the preoperative situation and the postoperative result after repairing the contour defect with a DIEP flap and subsequent liposculpture. British Journal of Plastic Surgery  , 2-13DOI: ( /j.bjps )

7 Figure 6 Case 5. (A) Aspect of the right thigh preoperative, chronic ulcer due to necrotising fasciitis, which has been skin grafted. (B) Aspect of the DIEP flap after the dissection. (C) The inset of the flap on the right thigh, note the midline scar. (D) Partial failure of the flap across the midline. (E) Final aspect after advancement of the flap and skin grafting the abdomen. British Journal of Plastic Surgery  , 2-13DOI: ( /j.bjps )

8 Figure 7 Case 6. Deep 3rd degree burns of both legs after application of a split DIEP flap, two TAP flaps, one distal lateral arm flap and a pedicled posterior tibial transposition flap. British Journal of Plastic Surgery  , 2-13DOI: ( /j.bjps )

9 Figure 8 Case 7. (A) Aspect of the leg at admission of the patient. (B) The freed DIEP flap of 50 by 17 cm. (C) Peroperative view showing the side-to-side anastomoses of the different pedicles onto the posterior tibial system. (D) Early postoperative result. British Journal of Plastic Surgery  , 2-13DOI: ( /j.bjps )


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