Background and objective.

The pedicled DIEP flap offers a reproducible alternative in the management of ischial and trochanteric ulcers where healthy peripheral tissue is not available for the realization of a local flap.

We describe the surgical technique and present 2 clinical cases in which this procedure has been used, offering a reproducible alternative in the treatment of these conditions.

Methods.

A doppler ultrasound scan of the periumbilical perforating arteries is carried out, tracing a 10 x 15 cm vertical skin island. The pedicle is dissected down to the junction with the deep inferior epigastric artery, which is dissected as proximal as possible. A subcutaneous tunnel is made to the area to be treated for the passage without tension of the vascular pedicle and the flap is placed in its receiving area, suturing it in two planes.

Results.

We present 2 clinical cases in which we obtained excellent functional results and low morbidity in the donor area.

Conclusions.

In our experience, the pedicled DIEP flap was an adequate reconstructive option in patients with ischial and trochanteric ulcers in whom peripheral tissues do not allow reconstruction with local flaps, since it has low morbidity in the donor area and a relatively long pedicle that allows it to reach the defect area.

Level of evidence

4d Therapeutic

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