The deep inferior epigastric perforator flap for breast reconstruction., the learning curve explored

The deep inferior epigastric perforator (DIEP) flap has been used as the principle tool. for secondary breast reconstruction in our department. This article details our experience in Learning and improving the technique with the help of an external team of experienced surgeons. In our initial 65 DIEP flap breast reconstructions our total flap toss rate was reduced from 9.5 to 0%, partial flap toss rate from 31 to 0%, and fat necrosis rate from 17 to 4.3%. We illustrate how a surgical team, which might initially have considered the complication rate from DIEP flap breast reconstruction too high, can benefit from a staged approach to this complex, but useful, reconstruction technique. (C) 2005 The British Association of Plastic Surgeons. Published by Elsevier Ltd. All rights reserved.