Free deep inferior epigastric artery perforator flap for reconstruction of soft-tissue defects in extremities of children.
Research article published in Microsurgery (2013)
Abstract
The deep inferior epigastric artery perforator (DIEP) flap has been a valuable tool in breast reconstruction, but seldom in extremity reconstruction. The aim of this report is to present our experience on the use of the DIEP flap for reconstruction of soft-tissue defects in the extremities of pediatric patients. From January 2007 to February 2011, 22 consecutive free DIEP flap transfers were performed for reconstruction of complex soft-tissue defects in the extremities of children with a mean age of 5.7 years old (ranging 2-10 years old). The flap design included transverse, oblique, and irregular DIEP flaps, containing one to three perforators in the flap. The flap size ranged from 7 × 4 cm to 18 × 17 cm. Primary donor-site closure was accomplished in all of patients. The postoperative course was uneventfully in most of cases. The venous congestion was observed in two cases. One case of venous congestion was caused by flap inset with tension. The other case with venous thrombosis ended with partial loss of the flap after salvage procedure. There was one total flap loss due to the arterial thrombosis. The flap survival rate was 95.5%. The mean follow-up was 12 months (ranging 6-36 months). All reconstructed extremities had satisfactory aesthetic and functional outcomes except two cases undergoing the secondary debulking procedures. The donor sites healed well in all cases without complications. Our experience showed that the free DIEP flap could be an alternative for reconstruction of soft-tissue defects in the extremities of children.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Free deep inferior epigastric artery perforator flap for reconstruction of soft-tissue defects in extremities of children.
Why This Matters for Hirudotherapy
This case series reports 22 consecutive free deep inferior epigastric artery perforator (DIEP) flap transfers for extremity soft-tissue reconstruction in pediatric patients (mean age 5.7 years), with a 95.5% flap survival rate and two cases of venous congestion, one resulting in partial flap loss. While venous congestion in flap surgery is a recognized clinical indication for medicinal leech therapy, this abstract makes no mention of leeches or hirudotherapy in the management of venous congestion. The study is focused on surgical technique and outcomes, so any leech-related relevance is unstated and speculative.
Citation
Free deep inferior epigastric artery perforator flap for reconstruction of soft-tissue defects in extremities of children.
Tang et al. · Microsurgery, 2013
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