DIEP stands for Deep Inferior (below the bellybutton in this case) Epigastric (the area of central abdomen lying just below the breastbone and above the bellybutton) Perforator (the vessel which supplies the skin and in this case perforates the rectus muscle (the muscle making the six pack at the front of the abdomen) a branch from the deeper lying Deep Inferior Epigastric Artery.
The operation takes about 8 hours, but can take longer, otherwise the post-operative period and the scars are the same as for a free TRAM.
The main difference between a DIEP and a free TRAM is that you avoid taking any of the rectus muscle and therefore avoid weakening the abdominal wall, lessening the chance of a hernia. Sometimes the course of the perforator vessel however is so tortuous through the muscle that the chance of damaging it is too high, so a small piece of muscle is taken, this is called a mini-TRAM or if a slightly bigger piece of muscle is taken a muscle sparing TRAM.
The potential complications of a DIEP flap are
Bad scars
Asymmetry
A collection of blood under the flap or the tummy, which needs removing in theatres
A collection of fluid (seroma) under the skin of the abdomen which needs repeated draining (probably the most common complication)
Flap failure
Deep Vein Thrombosis (DVT)
Pulmonary Embolus (arises from a DVT and is potentially fatal if not treated)
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