Complex Scalp Reconstruction with Super Thin DIEP Free Flap

This document discusses a complex scalp reconstruction case using a super thin deep inferior epigastric perforator (DIEP) free flap. The patient, a 67-year-old man with a history of metastatic lung cancer and radiation therapy, experienced wound breakdown and infection after a previous reconstructive attempt. Due to the large defect size, irradiated skin, and previous flap failure, a super thin DIEP flap was chosen for its long pedicle length and thin wound contour, offering a suitable solution for the patient's condition. The procedure involved a custom polyetheretherketone implant and successful flap coverage, resulting in good healing and cosmesis postoperatively. The case highlights the advantages of DIEP flaps in scalp reconstruction, particularly in challenging cases with complex medical histories.