{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T17:13:40Z","timestamp":1779383620318,"version":"3.53.1"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T00:00:00Z","timestamp":1744070400000},"content-version":"vor","delay-in-days":10,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Complex soft tissue defects in the lower limb pose significant challenges for surgeons, especially when extensive coverage is needed. Free flaps are preferred for their reliable soft tissue, with the deep inferior epigastric perforator (DIEP) flap being particularly advantageous in middle-aged women due to its ample tissue and the ability to perform abdominoplasty at the donor site. However, its bulkiness can be an issue for lower limb reconstruction. We present two cases where the DIEP flap was used for lower limb reconstruction with immediate flap thinning. By employing a unique thinning method based on the vascular connection between perforators, we successfully extended the flap's use without needing to anastomose the pedicles. All flaps were well-vascularized with no complications, demonstrating that maintaining the anterior fascia between perforators optimizes the DIEP flap for reconstructive purposes.<\/jats:p>","DOI":"10.1093\/jscr\/rjaf201","type":"journal-article","created":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T12:00:17Z","timestamp":1744113617000},"source":"Crossref","is-referenced-by-count":1,"title":["Extended DIEP flap with bilateral anterior fascia based on unilateral perforator for lower extremity reconstruction"],"prefix":"10.1093","volume":"2025","author":[{"given":"Tr\u1ea7n T","family":"S\u01a1n","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Hanoi Medical University , No 1 Ton That Tung, Kim Lien, Dong Da, Ha Noi 116177 ,","place":["Vietnam"]},{"name":"Department of Plastic Reconstructive and Aesthetic Surgery, University of Medicine and Pharmacy, Hanoi National University , No 144 Xuan Thuy, Dich Vong Hau, Cau Giay, Ha Noi 123105 ,","place":["Vietnam"]},{"name":"Department of Plastic Reconstructive and Aesthetic Surgery, Bach Mai Hospital , Hanoi, No 78 Giai Phong, Phuong Dinh, Dong Da, Ha Noi 116301 ,","place":["Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ph\u1ea1m T","family":"Vi\u1ec7t Dung","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Hanoi Medical University , No 1 Ton That Tung, Kim Lien, Dong Da, Ha Noi 116177 ,","place":["Vietnam"]},{"name":"Department of Plastic Reconstructive and Aesthetic Surgery, Bach Mai Hospital , Hanoi, No 78 Giai Phong, Phuong Dinh, Dong Da, Ha Noi 116301 ,","place":["Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T\u1ea1 T","family":"H\u1ed3ng Thu\u00fd","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Hanoi Medical University , No 1 Ton That Tung, Kim Lien, Dong Da, Ha Noi 116177 ,","place":["Vietnam"]},{"name":"Department of Plastic Reconstructive and Aesthetic Surgery, Bach Mai Hospital , Hanoi, No 78 Giai Phong, Phuong Dinh, Dong Da, Ha Noi 116301 ,","place":["Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ph\u1ea1m K","family":"Nh\u1eadt","sequence":"additional","affiliation":[{"name":"Department of Plastic Reconstructive and Aesthetic Surgery, Bach Mai Hospital , Hanoi, No 78 Giai Phong, Phuong Dinh, Dong Da, Ha Noi 116301 ,","place":["Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuru","family":"Sekido","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Institute of Medicine, University of Tsukuba , 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phan T","family":"Ngh\u0129a","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Hanoi Medical University , No 1 Ton That Tung, Kim Lien, Dong Da, Ha Noi 116177 ,","place":["Vietnam"]},{"name":"Department of Plastic Reconstructive and Aesthetic Surgery, Bach Mai Hospital , Hanoi, No 78 Giai Phong, Phuong Dinh, Dong Da, Ha Noi 116301 ,","place":["Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,4,8]]},"reference":[{"key":"2025040811332395200_ref1","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1097\/00000637-199401000-00007","article-title":"Deep inferior epigastric perforator flap for breast reconstruction","volume":"32","author":"Allen","year":"1994","journal-title":"Ann Plast Surg"},{"key":"2025040811332395200_ref2","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.1097\/01.prs.0000233604.86936.e8","article-title":"Perfusion zones of the DIEP flap revisited: a clinical study","volume":"118","author":"Holm","year":"2006","journal-title":"Plast Reconstr 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