Deep circumflex iliac perforator flap with iliac crest for mandibular reconstruction

The deep circumflex iliac myocutaneous perforator (DCIP) flap with iliac cr est was used to reconstruct oromandibular defects in 10 patients. In seven of the patients a dominant perforator was found preoperatively using a Dopp ler flowmeter; in five of these seven patients a DCIP flap was successfully transferred. In two of the seven patients the dominant perforators were to o narrow: one patient underwent a standard osteocutaneous flap transfer and one patient underwent a second flap transfer. In three patients no dominan t perforator was found before or during surgery. The freedom of the DCIP fl ap from the harvested iliac crest facilitates correct positioning. However, to ensure that the DCIP flap can be safety elevated, the presence of perfo rators must be confirmed preoperatively. Even when a perforator has been id entified, complicated dissection may be necessary. We stress the importance of a thorough knowledge of the anatomy of second flaps and of obtaining in formed consent to use them. (C) 2001 The British Association of Plastic Sur geons.