Herniation after deep circumflex iliac artery flap: two cases of rare complication

Herniation after harvesting of deep circumflex iliac artery (DCIA) flap is a known but not a common complication. It occurs about 2.8 to 9 % according to the literatures and can proceed to a more severe complication such as bowel obstruction. There are several factors that exacerbate the risk: surgical factors, operator factor, and patient factors. Surgical factors include large anatomical defect and denervation of related muscles. Operator factor stands for unpunctual suture technique. Patient factors represent obesity, diabetes, pulmonary disease, smoking habits, and so on. Thus, herniation might occur regardless of meticulous suture. Herein, we would like to report two cases of herniation after DCIA flap harvesting and repaired by Lichtenstein tension-free hernioplasty with literature review.