The deep circumflex iliac artery is the primary blood supply to the anterior iliac crest, making it the pedicle for the deep circumflex iliac artery (DCIA) free flap — the standard vascularised bone graft for mandibular reconstruction requiring a curved bone segment that can replicate the mandibular arch shape.
| Origin | External iliac artery just above the inguinal ligament |
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The DCIA free flap harvests the anterior iliac crest with its overlying skin and soft tissue based on the deep circumflex iliac artery pedicle. It provides 15 to 16 cm of curved vascularised bone with cortical and cancellous components, ideal for mandibular body reconstruction after resection for cancer or osteoradionecrosis. Donor site complications include hernia from the abdominal wall muscle disruption adjacent to the ASIS.
Iliac crest harvesting for DCIA free flap occasionally complicated by anterior abdominal wall hernia from damage to abdominal wall musculature adjacent to the harvest site.
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