{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:09:32Z","timestamp":1789085372680,"version":"build-2803163510"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,8,3]],"date-time":"2015-08-03T00:00:00Z","timestamp":1438560000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:p>The aim of this study was to analyze outcomes of patients who had prior abdominal operations and underwent DIEP flap breast reconstruction and to describe technical strategies to insure well\u2010vascularized flap\u2010harvest minimizing abdominal donor\u2010site complications. All patients who underwent DIEP flap breast reconstruction between 2004 and 2014 were reviewed and divided into a control group (CG) and a scar group (SG). Patient demographics, operative details, flap and donor\u2010site complications were analyzed and compared. For all of the scars, DIEP flap design was not modified, but a standardized approach was developed according to the type and location of the scar, available vascular pedicle, perforator locations, and the required flap tissue for breast reconstruction. Two hundred and eighty patients underwent 292 flaps in CG and 107 underwent 111 flaps in SG. Pfannenstiel, McBurney, laparoscopic, midline and subcostal were the most common previous incisions. There were no significant differences between groups regarding demographics, flap and mastectomy weight, active smoking, or radiation status (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05). No significant differences were observed in DIEP flap loss (<jats:italic>P<\/jats:italic>\u2009=\u20090.909), partial flap loss (<jats:italic>P<\/jats:italic>=0.799), or fat necrosis (<jats:italic>P<\/jats:italic>=0.871) and in the rate of abdominal donor\u2010site complications between groups (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05). SG had a significantly higher mean operative time than CG (<jats:italic>P<\/jats:italic>=0.034). Medial raw was a negative risk\u2010factor for flap complications, while BMI (&gt;25.1 kg\/m<jats:sup>2<\/jats:sup>) and smoking\u2010history were significant predictors for donor\u2010site complications. With careful preoperative planning and appropriate technical strategies, successfully DIEP flap breast reconstruction can be performed without increased flap and donor\u2010site complications in patients with preexisting abdominal scars. \u00a9 2015 Wiley Periodicals, Inc. 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