Clinical efficacy of pedicled double perforator deep inferior epigastric artery perforator flap in reconstructing defects following resection of cutaneous malignant tumors

Zhou Shuping; Zhang Dong; Wei Haili; Li Shimin; Chen Junjie; Li Sen; Shi Pancheng; Xing Xinfeng; Shi Yingguang; Chang Chaonan; Zheng Liwu; Wang Huanpeng; Gai Yuning

doi:10.3760/cma.j.cn501225-20250227-00096

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Article Navigation > CHINESE JOURNAL OF BURNS AND WOUNDS > > Accepted Manuscript

Zhou Shuping,Zhang Dong,Wei Haili,et al.Clinical efficacy of pedicled double perforator deep inferior epigastric artery perforator flap in reconstructing defects following tumor resection[J].Chin J Burns Wounds,2026,42(7):1-8.DOI: 10.3760/cma.j.cn501225-20250227-00096.

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Clinical efficacy of pedicled double perforator deep inferior epigastric artery perforator flap in reconstructing defects following resection of cutaneous malignant tumors

doi: 10.3760/cma.j.cn501225-20250227-00096

Department of Burns and Plastic Surgery, the 988th Hospital of the Joint Logistics Support Force of PLA, Zhengzhou 450007, China

Funds:

Medical Science and Technology Research and Development Plan Project of Henan Province of China LHGJ20240983

Optional Research Projects in Key Disciplines of the 988 Hospital of the Joint Logistics Support Force of PLA YNZX2025010

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Corresponding author: Li Shimin, Email:zsplovezyy@163.com
Received Date: 2025-02-27
Available Online: 2026-06-29

Abstract

Abstract

Objective To investigate the clinical efficacy of pedicled double perforator deep inferior epigastric artery perforator flap in reconstructing soft tissue defects following resection of cutaneous malignant tumors in the groin or thigh with adjacent major vessels and/or nerves. Methods This was a retrospective case series study. From June 2016 to June 2023, 12 patients with cutaneous malignant tumors in the groin or thigh who met the inclusion criteria were admitted to the Department of Burns and Plastic Surgery of the 988^th Hospital of the Joint Logistics Support Force of PLA. The cohort included 8 males and 4 females, aged 58 to 76 years. In all patients, tumor invasion depth approached the major vessels and/or nerves. Radical extended resection was performed for the tumors, resulting in postoperative skin and soft tissue defects ranging from 16 cm × 13 cm to 37 cm × 17 cm. A pedicled double perforator deep inferior epigastric artery perforator flap based on the paraumbilical and thoracic paraumbilical perforators was designed and harvested, with flap dimensions ranging from 15 cm × 14 cm to 38 cm × 18 cm. The flaps were transferred to the recipient site through a subcutaneous tunnel and sutured in place. Primary closure of the donor site was achieved in 8 patients; in the remaining 4 patients, the donor site wound was first reduced by approximation sutures, then covered with vacuum sealing drainage (VSD) dressing, with secondary closure performed at a later stage. Postoperative observations included flap blood supply, flap survival, occurrence of vascular crisis, and healing of donor and recipient sites. Operative duration and length of hospital stay were recorded. During follow-up, tumor recurrence, flap contour, donor site scar, and abdominal wall function were assessed. Results All 12 patients achieved good flap blood supply and uneventful survival, with no vascular crisis. Both donor and recipient sites healed successfully. Operative duration ranged from 2 to 3 hours, and hospital stay ranged from 15 to 24 days, with a mean of 18.6 days. During a follow-up period of 1 to 6 years, no local tumor recurrence was observed. The flaps were slightly bulky but demonstrated good elasticity and no significant difference in texture from the surrounding tissue. The donor site only exhibited a linear scar, with no significant impact on abdominal wall function. Conclusions For extensive soft tissue defects following radical resection of cutaneous malignant tumors in the groin or thigh adjacent to major vessels and/or nerves, the pedicled double perforator deep inferior epigastric artery perforator flap is a viable reconstructive option. This flap provides a large surface area for effective reconstruction while minimizing the impact on donor site aesthetics and function.
- Perforator flap,
- Microsurgery,
- Skin neoplasms,
- Malignant complex wounds,
- Wound repair

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References(40)

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