The versatility of deep inferior epigastric artery based rectus abdominis flap in covering various defects: a study in a tertiary hospital of eastern india

Objective: Deep inferior epigastric vascular system supplies a wide area of the anterior abdominal wall and offers a versatile variety of tissue combinations for local or free flap transfer. We conducted this study to analyse its utility.
Method: We conducted a review of all patients who underwent a reconstruction using the DIE based RAM flap between May 2017 and April 2018 in our institution. Indications for the flap, complication rates and outcomes and donor site morbidity were all observed.
Results: We conducted 12 DIEP based RAM flap procedures. Face (25%) and Perineum (25%) were the main recipient areas, followed by hip, theigh, leg, ankle and lower back (8.6%). Primary closure without prolene mesh was done for donor site management in 41.6% cases and the rest of 58.4% cases required closure with prolene mesh reinforcement. Of the 12 cases there was no cases of complete flap necrosis, five(41.6%) flaps had complete survival, four(33.3%) flaps underwent partial necrosis and in three(25%) cases there is partial loss of STSG. Among the donor sites in the twelve cases eight(66.6%) had no complications, remaining four(33.3%) cases one each had complications like wound dehiscence, discharge, ulceration and pain. There is no significant statistical association between complications and types of flap used.
Conclusions: This flap is versatile 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.