THE EXTENDED DEEP INFERIOR EPIGASTRIC PEDICLE FLAP FOR LOWER-EXTREMITY RECONSTRUCTION

Large soft-tissue defects of the lower extremity can present a challen ging reconstructive problem. The extended deep inferior epigastric ped icle flap is a versatile and reliable flap that can be used for the co verage of complex lower extremity soft-tissue defects as far distal as the knee. We reviewed our 5-year experience with 20 consecutive exten ded deep inferior epigastric pedicle flaps used to cover lower extremi ty defects. All wounds, including 4 soft-tissue defects of the knee, w ere successfully covered. Two minor complications occurred. Flap anato my, surgical approach, and new refinements in flap design are presente d. The indications for the flap and its role in ablative tumor surgery are discussed. This flap has proved to be versatile, easy to raise, a nd extremely hardy. The ample skin island with its large arc of rotati on is well vascularized, healing well even in irradiated wounds, and t he flap tolerates both postoperative pressure and radiation.