Thoracodorsal Artery Perforator Flap, A Workhorse Flap | ||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||
| Article 11, Volume 49, Issue 1, January 2025, Pages 81-89 PDF (1.51 M) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejprs.2025.405241 | ||
| Authors | ||
| Mohamed Abdallah El Nahas; Fouad Mohamed Ghareeb; Mohamed Salah Abolhoda* | ||
| The Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Menoufia University | ||
| Abstract | ||
| Background: Improvements in our knowledge of vascular anatomy have enabled the design of a new type of fascio- cutaneous flaps, which are based on perforating vessels only. Thus, donor site morbidity is markedly reduced. Objective: Our study aimed to ease flap harvest, shorten operation time, minimize donor site morbidity, maximize esthetic outcome, decrease complication rates and post-operative recovery time and therefore TDAP flap is considered as a work horse flap. Methods: The authors describe their experience about the role of TDAP flap in reconstruction of different complex tissue defects. Representative cases are presented for illustration. Results: We conducted a study involving 24 patients who underwent TDAP flap reconstructions from January 2022 to April 2024. The patients aged 4 to 49 years. Flaps ranged in size from 12cm × 6cm to 26cm × 15cm. In 12 cases, one perforator was identified: In 9 cases, two perforators and in 3 cases, three perforators. Free TDAP flaps were used in 17 cases, while pedicled flaps were used in 7 cases. The donor site was primarily closed in all cases without any movement restrictions. There was one case of partial flap loss, but no cases of total flap loss occurred. Conclusions: TDAP flap provides a reliable and versatile option for plastic surgeons in the reconstruction of complex soft tissue defects with limited donor site morbidity and excellent functional and esthetic results. | ||
| Keywords | ||
| Thoracodorsal; Free; Flap; Pedicled | ||
| References | ||
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Lee K.T., Wiraatmadja E.S. and Mun G.H.: Free latissimus dorsi muscle-chimeric thoracodorsal artery perforator flaps for reconstruction of complicated defects: Does muscle still have a place in the domain of perforator flaps? Ann. Plast. Surg., May 74 (5): 565-72, 2015. 2- Homsen J.B. and Gunnarsson G.L.: The evolving breast reconstruction: From latissimus dorsi musculocutaneous flap to a propeller thoracodorsal fasciocutaneous flap. Gland Surg., Aug. 3 (3): 151-4, 2014. 3- Feng A.L., Nasser H.B., Rosko A.J., Casper K.A., Malloy K.M., Stucken C.L., Prince M.E., Chinn S.B. and Spector M.E.: Revisiting pedicled latissimus dorsi flaps in head and neck reconstruction: Contrasting shoulder morbidities across myofascial flaps. Plast. Aesthet. Res., 2021; 8:10.20517/2347-9264.2021.03. 4- Chen S.L., Chen T.M. and Wang H.J.: Free thoracodorsal artery perforator flap in extremity reconstruction: 12 cases. Br. J. Plast. Surg., 57: 525-30, 2004. 5- Park B.Y.: Flap thinning: Defatting after conventional elevation. Arch. Plast. Surg., Jul. 45 (4): 314-318, 2018. 6- Sever C., Uygur F., Kulahci Y., Karagoz H. and Sahin C.: Thoracodorsal artery perforator fasciocutaneous flap: A versatile alternative for coverage of various soft tissue defects. Indian J. Plast. Surg., Sep. 45 (3): 478-84, 2012. 7- Ezequiel Escudero, Ludmila Grassano, Claudio Angrigiani, Alberto Rancati, Roger K. and Khouri Jr., B.S.: Thoracodorsal Artery Perforator Flap for Bilateral Breast Reconstruction: Simultaneous Vs Staged. Michigan Journal of Medicine, April Volume 2, Issue 1, 2017. 8- Mustafa A.Y.A.A. and Alasmari W.: Anatomical Study of the Latissimus Dorsi Muscle Flap. Int. J. Morphol., Vol. 40, n.3, pp.562-565, 2022. 9- Hassan K., Awadein A. and Abdelhamid M.: Neurovascular Anatomy of the Split Latissimus Dorsi Muscle Flap for the Purpose of Smile Restoration. The Egyptian Journal of Plastic and Reconstructive Surgery, 43 (3): 565-573, 2019. 10- Li S-Q., Zheng Z-F., Li H., Zhang J-F., Zheng Y. and Lin L-S.: Clinical Study on the Thoracodorsal Artery Perforator Flap in Breast-Conserving Reconstruction of T2 Breast Cancer. Surgical Innovation, 31 (1): 16-25, 2024. 11- Tansatit T., Chokrungvaranont P., Wanidchaphloi S. and Sanguansit P.: The anatomy of the thoracodorsal artery in perforator flap for resurfacing shallow defect. J. Med. Assoc. Thai., May 90 (5): 947-55, 2007. 12- Hifny M.A., Tohamy A.M.A., Rabie O. and Ali A.A.A.: Propeller perforator flaps for coverage of soft tissue defects in the middle and distal lower extremities, Annales de Chirurgic Plastique Esthétique, Volume 65, Issue 1: 54- 60, 2020. 13- Hantash S., Ayad W., Hendy A.A. and Sadaka M.S.: Clinical applications of the thoracodorsal artery perforator flap in extremity soft tissue reconstruction. The Egyptian Journal of Plastic and Reconstructive Surgery, 44 (2): 353-359, 2020. 14- Dias, Leonardo Pires Novais, Marzia Salgarello and Moustapha Hamdi: “History of Pedicled Perforator Flaps for Breast Reconstruction.” Pedicled Flaps in Partial Breast Reconstruction. Springer International Publishing, 1-18, 2023. 15- Angrigiani C., Grilli D. and Siebert J.: Latissimus dorsi musculocutaneous flap without muscle. Plast. Reconstr. Surg., 96: 1608–14, 1995. | ||
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