Published online Feb 6, 2024. doi: 10.12998/wjcc.v12.i4.828
Peer-review started: October 16, 2023
First decision: December 5, 2023
Revised: December 22, 2023
Accepted: January 15, 2024
Article in press: January 15, 2024
Published online: February 6, 2024
Pedicled abdominal flaps are a widely used surgical technique for forearm reconstruction in patients with soft tissue defects. However, some drawbacks include restricted flap size, partial flap loss, and donor-site morbidity. To address these concerns, we present a case of a pedicled abdominal flap using the deep inferior epigastric artery perforators (DIEP) for forearm reconstruction in a patient with a large soft tissue defect.
A 46-year-old male patient was admitted to our hospital with forearm injury caused by a pressing machine. A 15 cm × 10 cm soft tissue defect with complete rupture of the ulnar side structures of the forearm was found. One week after orthopedic management of the neurovascular injury and fractures using the first stage of Masquelet technique, the patient was referred to the plastic and recon
Pedicled abdominal flap using the DIEP provides a reliable option for forearm reconstruction in patients with large soft tissue defects.
Core Tip: Compared to traditional pedicled groin and abdominal flaps for forearm reconstruction, pedicled abdominal flap with the deep inferior epigastric artery perforators offer a more robust blood supply and larger soft tissue, reducing the risk of flap necrosis. In addition, it eliminates the need for anastomoses, reduces operative time, and allows direct closure of the donor site aesthetically without skin grafts. Using computed tomography angiography and handheld Doppler can help surgeons find appropriate perforators vessels during surgery. This report provides a suitable option for managing complex upper extremity injuries and providing adequate soft tissue coverage with minimal donor-site morbidity.