DIEP flap reconstruction for sacrectomy defects: Two case reports

Abstract

Introduction: Vertical rectus abdominis myocutaneous (VRAM) flap is the most common option for large sacral defect reconstruction but is known to have donor-site abdominal morbidity compared to deep inferior epigastric perforator (DIEP) flaps.

Report: Fifty-seven and 63 year-old men were admitted for large sacral soft tissue defects after tumour excisions. They both underwent an inferiorly based pedicled vertical DIEP flap passed transabdominally with successful postoperative outcomes and not any abdominal wall complication.

Discussion: Since the introduction of perforator flaps, using DIEP flap allows reducing donor-site complication rate. These two cases are the first DIEP flaps in sacral defects coverage suggesting DIEP flap may be a reliable option with superiority due to low donor-site morbidity compared to the gold standard VRAM flap.

Keywords: Chirurgie plastique; Deep inferior epigastric perforator; Deep inferior epigastric perforator flap; Perineal reconstruction; Perte de substance sacrée; Plastic surgery; Reconstruction périnéale; Sacral defect.