Microsurgery: Transplantation and Replantation by Harry J. Buncke, MD, et al.
  Table of Contents / Chapter 7:
Bilateral Inferior Epigastric Flap (BIEF)
  FIG. 7-34. Normal projection and ptosis can be achieved with this amount of tissue without silastic implants. Front view.

FIG. 7-35. Oblique view.


A 32-year-old woman had severe scarring limiting elbow motion after a degloving injury of the arm.

FIG. 7-36. Preoperative appearance in extension.

FIG. 7-37. Preoperative appearance in flexion.

FIG. 7-38. The BIEF is outlined on the abdomen.

FIG. 7-39. The scar contracture and old skin grafts have been excised, releasing the elbow contracture.

FIG. 7-40. The BIEF has been transplanted to the arm.

FIG. 7-41. End-to-side repairs were performed between the brachial vessels and the right BIEF pedicle and the distal ulnar vessels to the left pedicle.

FIG. 7-42. The distal third of the flap was lost due to thrombosis of the left repair.

FIG. 7-43. Full flexion and extension of the elbow were restored.



A patient had severe scarring and entrapment after clostridial infection, fasciotomies, and skin grafting.

FIG. 7-44. Preoperative appearance.

FIG. 7-45. The template is used to outline the donor flap. Few flaps other than the BIEF could provide this conFIGuration.

FIG. 7-46. The flap is isolated on BIEF pedicles.

FIG. 7-47. Early follow-up shows excellent coverage and release and protection of ulnar nerve. Extension.

FIG. 7-48. Full flexion.


1. Shaw, D.T., and Payne, R.P. One-staged tube abdominal flaps. Surg. Gynecol. Obstet. 83:205, 1946.

2. LeQuang, C.: Microvascular tissue transfer in plastic surgery. In Microsurgery: Proceedings of the International Congress of the International Microscopical Society. Edited by T.S. Lie, Amsterdam, Excerpta Medica, 1979.

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