To explore the clinical application of delayed pedicled deep inferior epigastric perforator (DIEP) flap transfer for repairing large forearm soft tissue defects.

From January 2012 to January 2018, nine patients with large soft-tissue defects in the forearm underwent reconstruction by delayed pedicled DIEP flap transfer at Lanzhou Hand and Foot Surgery Hospital, and the clinial effect was analyzed. They ranged in age from 18 to 51 years (mean, 36 years). The size of soft-tissue defects in the forearm ranged from 24.0 cm×8.0 cm to 32.0 cm×8.5 cm. The lateral branch provided the blood supply to the DIEP flap. The donor site was closed directly. Time of flap delay was 6~10 d. Time of pedicle break was 18-21 d.

One patient developed small wound dehiscence, which spontaneously healed two weeks after surgery. All the flaps had survived completely. Postoperative follow-up period ranged from 2.0 to 4.5 years (mean, 3.8 years). The incision healed well, no abdominal incision hernia occurred, and no obvious dysfunction was found. A good contour was confirmed at the recipient area. Satisfactory clinical results were obtained in the cases.

Delayed pedicled DIEP flap transfer is a good option to repair large soft tissue defects in the forearm. This technique is safe and reliable, with minimal donor site morbidity.