The pedicled 'propeller' deep inferior epigastric perforator (DIEP) flap for a large abdominal wall defect.

The deep inferior epigastric perforator (DIEP) flap has become a popular free flap for use in breast reconstruction, providing a versatile volume of tissue with low donor site morbidity and in particular its ease of direct donor site closure. While its use in free tissue transfer has been widely reported, its use as a local pedicled flap has been more scarcely described. Limited reports include its use for hip and groin defects and in penile reconstruction. A long and robust vascular pedicle is ideal for islanded local advancement or so-called 'propeller' rotation to adjacent abdominal wall defects, with Seyhan and Borman (2008) describing such a technique for coverage of the lower abdominal wall, and we have described such a technique to aid closure of the lower abdominal wall during contralateral DIEP flap harvest. Having been presented with a large central-lower anterior abdominal wall defect, we describe a further application of the pedicled 'propeller' DIEP flap.