Banking a hemiabdominal DIEP flap: oncologic indications.

We read with great interest the article by Shridharani et al. (2009) describing the banking of a surplus hemiabdominal deep inferior epigastric artery perforator (DIEP) flap for future use. The authors describe a novel surgical technique and useful indication, particularly in the case of difficult flap harvest and/or junior microsurgical staff. We have also described a similar technique of banking the surplus hemiabdominal flap (article still in press), however, our experience comprises a different surgical technique and different indications for its application, the discussion of which may contribute to the more widespread applicability of the technique. Shrindharani et al. describe a series of cases in which the banking of a hemiabdominal DIEP flap was able to maintain a reconstructive option for 4–5 days in the case of potential flap failure. While this indication may have its applicability, we have employed the technique for oncologic reasons. In cases of oncologic resection where immediate reconstruction with a DIEP flap is required, usually for skin coverage, but where the need for further resection may necessitate a subsequent reconstructive option, the banking of an unused hemiabdominal DIEP flap can spare the need for a secondary donor site. Histopathological examination of the initial specimen is usually performed within 5 days, and thus, this can be