DIEP Flap in Post-Mastectomy Breast Reconstruction: Surgical Innovation and Its Effect on Patients' Functional and Psychological Recovery

Resumen

The DIEP (Deep Inferior Epigastric Perforator) flap represents a key innovation in post-mastectomy breast reconstruction. This microsurgical technique uses tissue (skin and fat) from the patient’s lower abdomen to recreate the breast, with the unique advantage of preserving the rectus abdominis muscle. This distinguishes it from older methods like the TRAM flap, which involved cutting the muscle. Muscle preservation results in less donor site morbidity, faster functional recovery, and less pain, as well as a reduced risk of hernias or abdominal wall weakening. The literature reviewed for this research is based on a synthesis of information from the provided documents, which include meta-analyses, case series, and thematic reviews published in recent years following the guidelines of the systematic review manual and the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement flowchart. A structured approach was followed for the information synthesis. Document selection was performed by identifying and extracting key data directly related to the study's objectives. Subsequently, the relevance and quality of each piece of information was evaluated for its inclusion. Breast reconstruction with a DIEP flap is the post-mastectomy gold standard because it preserves the abdominal muscle, significantly reducing complications and accelerating recovery, unlike older techniques like the TRAM. The choice of this procedure is an individualized process that requires the coordination of medical teams, but current literature has a key limitation: the lack of data on the long-term impact on patients' return to work and sexual life. Despite the complexity of the procedure, its widespread adoption and surgeon training are emphasized, as it represents a clinically and economically superior option for improving patients' long-term quality of life.