A Study of deep inferior epigastric artery-based rectus abdominis flap in covering various defects

Background: Flaps based on deep inferior epigastric (DIE) vascular system; local, regional or free flaps: can be designed with different tissue compositions to cover a wide variety of defects. Aims and Objectives: The versatile utility of DIE flap was analyzed in this study. Materials and Methods: All patients who underwent a reconstruction using the DIE-based rectus abdominis muscle (RAM) flap between May 2016 and November 2017 were studied. Indications for the procedure, outcome, complications and donor site morbidity were all observed. Results: We conducted 11 DIE artery-based RAM flap procedures. Face (25%) and Perineum (25%) were the main recipient areas, followed by hip, thigh, leg, ankle, and lower back (8.6%). Primary closure without prolene mesh was done for donor site management in 41.6% cases and in the rest of 58.4% cases, closure required prolene mesh reinforcement. Not a single case suffered complete flap necrosis, five (41.6%) flaps had complete survival, four (33.3%) flaps underwent partial necrosis and in two (18.2%) cases there was partial loss of split-thickness skin grafts. Among the donor sites in the 11 cases, eight (72.7%) had no complications, among remaining three (33.3%) cases one each had complications such as wound dehiscence, discharge, ulceration, and pain. Conclusion: This flap can be used in various manners, it provides cutaneous cover that can be used anywhere. It can be used as a pedicled flap for perineal, inguinal, upper thigh regions and as a free flap, resurfacing anywhere from head to foot including the sole. It is versatile in the orientation and low donor site morbidity.