Breast Reconstruction with Free DIEP Flap: Analysis of the First 14 Cases at an Oncology Branch Hospital

Abstract

ABSTRACT Purpose: The Deep Inferior Epigastric Perforator (DIEP) flap is the gold standard for autologous breast reconstruction due to its aesthetic outcomes and high patient satisfaction. This study evaluates the clinical outcomes and complications of the first 14 DIEP flap reconstructions performed at an oncology hospital. Methods: Twelve patients (14 reconstructions) who underwent DIEP flap breast reconstruction between 2023 and 2024 were included. Preoperative CT angiography was used to map perforator vessels. Patient demographics, operative details (ischemia time, perforator count, and operative duration), and postoperative outcomes were analyzed. Patients were followed for at least six months. Results: The mean patient age was 47.17 years. Operative times averaged 5 hours 23 minutes for unilateral and 7 hours 28 minutes for bilateral reconstructions. Two patients experienced venous congestion, successfully managed with superficial inferior epigastric vein (SIEV) anastomosis. Partial flap necrosis occurred in one patient, and fat necrosis was observed in two. Donor site dehiscence occurred in two smokers, one with diabetes mellitus. No total flap loss or vascular re-exploration was required. Four patients underwent corrective surgeries for aesthetic purposes. The complication rates were consistent with the literature. Conclusion: The DIEP flap is a safe and effective option for breast reconstruction with favorable aesthetic and functional outcomes. While technical expertise is essential, this study demonstrates the feasibility of implementing DIEP flap procedures in oncology centers. Larger studies with extended follow-up are needed to validate these findings and optimize complication management.