A free flap is a technique in plastic and reconstructive surgery where any type of tissue is lifted and completely detached from its original location (donor site) and transplanted to another distant location (recipient site). This is distinct from a pedicled flap, in that the transplanted tissue is completely detached from its blood supply at the original location and requires reconnection of an artery and vein at the recipient site to re-establish circulation.
Deep Inferior Epigastric Artery Perforator (DIEP) Flap
The DIEP flap can be used for a variety of reconstructive procedures when a large segment of soft tissue, including fat and skin is necessary. It has become more popular for breast reconstruction, but requires significant microsurgical experience to harvest.
The serratus anterior muscle takes origin from the lateral scapula and fans anteriorly as it inserts into the first nine ribs. Only a portion of the muscle is used for flap reconstruction: the lower three slips of muscle arise at the very inferior scapula and have an independent blood and nerve supply, making them a good source of a medium to small sized muscle for free flap coverage.
All images and links used with permission from Dr. Rudy Buntic.