{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T10:48:36Z","timestamp":1786618116424,"version":"build-2736575974"},"reference-count":12,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,7,13]],"date-time":"2017-07-13T00:00:00Z","timestamp":1499904000000},"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":[[2018,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In free\u2010flap reconstruction of the lower extremity, due either to trauma or pre\u2010existing vascular disease, healthy vessels may not be readily available in the proximity of the defect. A variety of options including a cross\u2010leg free flap, vein grafts, arteriovenous loops, and \u201cbridging\u201d flaps have been used to address the issue. The purpose of this report is to present a case in which a 72\u2010cm long extended bilateral deep inferior epigastric artery perforator (DIEP) free flap was used for coverage of a 20 \u00d7 25 cm soft tissue defect of the lower leg following a Gustilo grade IIIC fracture in a 29\u2010year\u2010old man. Because usable recipient vessels were far from the zone of injury, and to avoid complications accompanying long vein grafts, a long flap was necessary. The exposed tibia required coverage with a free flap, but peripheral portions of the defect with exposed muscles could be covered with a skin graft. Thus, a 72 \u00d7 12 cm flap was chosen. The flap was based on both bilateral DIEPs and on the superficial circumflex iliac artery (SCIA). The flap survived completely with no complications. After one debulking surgery, the flap and the donor site showed pleasing cosmesis, and the patient could walk without crutches at 18 months after the first surgery. In cases where no healthy recipient vessels can be found close to the defect, we believe that the use of an extended bilateral DIEP flap may be a feasible option which shortens or precludes vein grafts with no additional flap donor sites.<\/jats:p>","DOI":"10.1002\/micr.30202","type":"journal-article","created":{"date-parts":[[2017,7,13]],"date-time":"2017-07-13T15:13:26Z","timestamp":1499958806000},"page":"89-93","source":"Crossref","is-referenced-by-count":11,"title":["Use of a 72\u2010cm\u2010long extended bilateral deep inferior epigastric artery perforator free flap for reconstruction of a lower leg with no suitable recipient vessel around the injury zone: A case report"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5427-817X","authenticated-orcid":false,"given":"Hidehiko","family":"Yoshimatsu","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Graduate School of Medicine, University of Tokyo 7\u20103\u20101 Hongo, Bunkyo\u2010ku Tokyo 113\u20108655 Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takumi","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Graduate School of Medicine, University of Tokyo 7\u20103\u20101 Hongo, Bunkyo\u2010ku Tokyo 113\u20108655 Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akitatsu","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Graduate School of Medicine, University of Tokyo 7\u20103\u20101 Hongo, Bunkyo\u2010ku Tokyo 113\u20108655 Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0803-5254","authenticated-orcid":false,"given":"Takuya","family":"Iida","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Graduate School of Medicine, University of Tokyo 7\u20103\u20101 Hongo, Bunkyo\u2010ku Tokyo 113\u20108655 Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,7,13]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.1920140803"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198904000-00022"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199709000-00016"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-199506000-00011"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1006914"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1285821"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-198908000-00005"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.4103\/0970-0358.90808"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.TA.0000114637.29779.AB"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.22410"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2013.09.011"},{"key":"e_1_2_6_13_1","first-page":"507","volume-title":"Plastic surgery","author":"Wei F. 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