The Deep Inferior Epigastric Artery Perforator Free Flap in Head and Neck Reconstruction: A Systematic Review.

ABSTRACT Background Perforator flaps obtain the best results for the patient with the least morbidity, and should be considered the gold standard in head and neck reconstruction. Despite deep inferior epigastric perforator flap is considered the gold standard in breast reconstruction, its use in head and neck reconstructive surgery does not seem so widespread. The objective of this study was to conduct a systematic review of the use, applications and results of the DIEP flap in the head and neck area Methods Search was conducted in different indexed databases (PubMed/MEDLINE, the Cochrane Library, Scielo and Web of Science) and the and through meta-searcher Trip Database with deep inferior epigastric perforator flap AND head neck keywords. Animal and human experimental published studies in peer-reviewed journals where investigators assessed the use of DIEP flap, according to the Koshima criteria, in the head and neck area were considered. Results A total of 31 articles and 185 flaps with a 95% of survival were found. Thrombosis or venous stasis is the most frequent cause of flap loss and. A 16.1% presented some type of complication, the most frequent being the dehiscence. The most use was in the reconstruction of glossectomy defect secondary to squamous cell carcinoma (30.51%), being able potentially to re-establish sensory innervation in oral cavity. The assessment of risk bias (NIH) highlights the lack of uniformity, with no standardization of the outcome variables collection and monitoring. Discussion Virtue of its versatility, reliable vascular supply, and high flap survival rate, the deep inferior epigastric perforator flap reconstruction could be an option in complicated 3-dimensional head and neck defects while maintaining the standard of low donor site morbidity.