Thoracodorsal artery perforator flap in immediate breast reconstruction: a series of twenty cases
DOI:
https://doi.org/10.18203/2349-2902.isj20195971Keywords:
Breast reconstruction, Oncoplastic surgery, Perforator flapAbstract
Background: The management of breast cancer has shown a progressive change, from radical ablative surgery, to breast conserving techniques. Traditionally, the mini latissimus dorsi flap has been used for reconstruction; which is associated with donor site morbidity. Vascular research has now allowed the use of perforator-based flaps for reconstruction, which reduce donor site morbidity.
Methods: Twenty thoracodorsal perforator flaps in twenty early breast cancer patients were studied between January 2018 and December 2018. Parameters studied were adequacy of volume, ease and time taken for flap elevation, and final aesthetic outcome.
Results: Flap volume was adequate to fill defect. One of twenty cases had flap loss due to venous congestion secondary to pedicle kinking. Average time taken for flap elevation was 70.45 minutes. All patients were satisfied with cosmetic outcome.
Conclusions: The TDAP flap is a safe and reliable flap which provides adequate volume for partial breast reconstruction.
References
Noguchi M, Yokoi-Noguchi M, Ohno Y, Morioka E, Nakano Y, Kosaka T, et al. Oncoplastic breast conserving surgery: volume replacement vs. volume displacement. Eur J Surg Oncol. 2016;42(7):926-34.
Hamdi M, Rasheed MZ. Advances in autologous breast reconstruction with pedicled perforator flaps. Clin Plastic Surg. 2012;39(4):477-90.
Hamdi M, Wolfli J, Van Landuyt K. Partial Mastectomy Reconstruction. Clin Plastic Surg. 2007;34:51-62.
Hamdi M, Van Landuyt K, Monstrey S, Blondeel P. Pedicled perforator flaps in breast reconstruction: a new concept. Bri J Plastic Surg. 2004;57(6):531-9.
Hamdi M, Van Landuyt K, Hijjawi JB, Roche N, Blondeel P, Monstrey S. Surgical technique in pedicled thoracodorsal artery perforator flaps: a clinical experience with 99 patients. Plastic Reconstruct Surg. 2008;121(5):1632-41.
Angrigiani C, Grilli D, Siebert J. Latissimus dorsi musculocutaneous flap without muscle. Plastic a Reconstruct Surg. 1995;96(7):1608-14.
Guerra AB, Metzinger SE, Lund KM, Cooper MM, Allen RJ, Dupin CL. The thoracodorsal artery perforator flap: Clinical experience and anatomic study with emphasis on harvest techniques. Plastic Reconstruct Surg. 2004;114(1):32-41.
Spinelli HM, Fink JA, Muzaffar AR. The latissimus dorsi perforator-based fasciocutaneous flap. Annal Plastic Surg. 1996;37(5):500-6.
Lin CT, Huang JS, Yang KC, Hsu KC, Chen JS, Chen LW. Reliability of anatomical landmarks for skin perforators of the thoracodorsal artery perforator flap. Plastic Reconstruct Surg. 2006;118(6):1376-86.
Thomas BP, Geddes CR, Tang M, Williams J, Morris SF. The vascular basis of the thoracodorsal artery perforator flap. Plastic Reconstruct Surg. 2005;116(3):818-22.
Heitmann C, Guerra A, Metzinger SW, Levin LS, Allen RJ. The thoracodorsal artery perforator flap: Anatomic basis and clinical application. Annal Plastic Surg. 2003;51(1):23-9.
Randolph LC, Barone J, Angelats J, Dado DV, Vandevender DK, Shoup M. Prediction of postoperative seroma after latissimus dorsi breast reconstruction. Plasticand Reconstruct Surg. 2005;116(5):1287-90.
