DIEP Flap in Head and Neck Reconstructions

  • M. Pignatti
  • G. Sapino
  • L. Pacchioni
  • A. Baccarani
  • G. De Santis


Even if the deep inferior epigastric perforator (DIEP) free flap has become popular among plastic surgeons mostly for breast reconstruction, its use to restore head and neck defects has been widely documented in the literature, particularly when additional tissue bulk is required.

The aim of this chapter is to present the anatomical feature, the harvesting technique and the specific indication related to the use of DIEP flap in head and neck reconstruction.


  1. 1.
    Song R, Gao Y, Song Y, Yu Y, Song Y. The forearm flap. Clin Plast Surg. 1982;9(1):21–6.PubMedGoogle Scholar
  2. 2.
    Song YG, Chen GZ, Song YL. The free thigh flap: a new free flap concept based on the septocutaneous artery. Br J Plast Surg. 1984;37(2):149–59.CrossRefGoogle Scholar
  3. 3.
    Koshima I, Soeda S. Inferior epigastric artery skin flaps without rectus abdominis muscle. Br J Plast Surg. 1989;42(6):645–8.CrossRefGoogle Scholar
  4. 4.
    Allen RJ, Treece P. Deep inferior epigastric perforator flap for breast reconstruction. Ann Plast Surg. 1994;32(1):32–8.CrossRefGoogle Scholar
  5. 5.
    Clemens MW, Davison SP. Buried deep inferior epigastric perforator flaps for complex head and neck contour defects. J Reconstr Microsurg. 2009;25(2):81–8. Epub 2008 Oct 15CrossRefPubMedGoogle Scholar
  6. 6.
    Beausang ES, McKay D, Brown DH, Irish JC, Gilbert R, Gullane PJ, Lipa JE, Neligan PC. Deep inferior epigastric artery perforator flaps in head and neck reconstruction. Ann Plast Surg. 2003;51(6):561–3.CrossRefGoogle Scholar
  7. 7.
    López-Arcas JM, Arias J, Morán MJ, Navarro I, Pingarrón L, Chamorro M, Burgueño M. The deep inferior epigastric artery perforator (DIEAP) flap for total glossectomy reconstruction. J Oral Maxillofac Surg. 2012;70(3):740–7. Epub 2011 Jul 29CrossRefPubMedGoogle Scholar
  8. 8.
    Woodworth BA, Gillespie MB, Day T, Kline RM. Muscle-sparing abdominal free flaps in head and neck reconstruction. Head Neck. 2006;28(9):802–7.CrossRefGoogle Scholar
  9. 9.
    Louie O, Dickinson B, Granzow J, Boyd JB. Reconstruction of total laryngopharyngectomy defects with deep inferior epigastric perforatorflaps. J Reconstr Microsurg. 2009;25(9):555–8. Epub 2009 Aug 20CrossRefPubMedGoogle Scholar
  10. 10.
    Yano T, Sakuraba M, Asano T, Sarukawa S. Head and neck reconstruction with the deep inferior epigastric perforator flap: a report of twocases. Microsurgery. 2009;29(4):287–92. Scholar
  11. 11.
    Koshima I, Nanba Y, Tsutsui T, Takahashi Y, Watanabe A, Ishii R. Free perforator flap for the treatment of defects after resection of huge arteriovenous malformations in the head and neck regions. Ann Plast Surg. 2003;51(2):194–9.CrossRefGoogle Scholar
  12. 12.
    Koshima I, Moriguchi T, Soeda S, Tanaka H, Umeda N. Free thin paraumbilical perforator-based flaps. Ann Plast Surg. 1992;29(1):12–7.CrossRefGoogle Scholar
  13. 13.
    Munhoz AM, Ishida LH, Sturtz GP, Cunha MS, Montag E, Saito FL, Gemperli R, Ferreira MC. Importance of lateral row perforator vessels in deep inferior epigastric perforator flap harvesting. Plast Reconstr Surg. 2004;113(2):517–24.CrossRefGoogle Scholar
  14. 14.
    Hartrampf CR, Scheflan M, Black PW. Breast reconstruction with a transverse abdominal island flap. Plast Reconstr Surg. 1982;69(2):216–25.CrossRefGoogle Scholar
  15. 15.
    Holm C, Mayr M, Höfter E, Ninkovic M. Perfusion zones of the DIEP flap revisited: a clinical study. Plast Reconstr Surg. 2006;117(1):37–43.CrossRefGoogle Scholar
  16. 16.
    Saint-Cyr M, Wong C, Schaverien M, Mojallal A, Rohrich RJ. The perforasome theory: vascular anatomy and clinical implications. Plast Reconstr Surg. 2009;124(5):1529–44. Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • M. Pignatti
    • 1
  • G. Sapino
    • 2
  • L. Pacchioni
    • 2
  • A. Baccarani
    • 2
  • G. De Santis
    • 2
  1. 1.Department of Plastic and Reconstructive Surgery Department of Otolaryngology Department of Plastic and Reconstructive SurgeryS. Orsola-Malpighi University HospitalBolognaItaly
  2. 2.Department of Plastic and Reconstructive SurgeryUniversity Hospital of ModenaModenaItaly

Personalised recommendations