Clinical Applications of the Thoracodorsal Artery Perforator Flap in Extremity Soft Tissue Reconstruction

Hantash, Sherif A; Ayad, Wael; Hendy, Amgad A.; Sadaka, Mohamed Saad

doi:10.21608/ejprs.2020.113498

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…Because the defects are usually large and accompanied by exposure of nerves, vessels, bones, or tendons [1] . Local soft tissues are commonly not available for usage as a coverage in cases suffering a permanent high impact injury [1][2][3] . Free tissue transfer might be only surgical option in the vast majority of patients.…”

Section: Introductionmentioning

confidence: 99%

Versatility of scapular and parascapular free flaps in limb reconstruction

Khalifa,

Zayed,

Shalaby

et al. 2024

Int. J. Surg. Sci.

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Background: Reconstructing the soft tissue defects caused by trauma in the extremities remains a challenging procedure in reconstructive surgery. The present work aimed at evaluating the versatility of scapular and parascapular free flaps in limb soft tissue defects reconstruction. Methods: This work was a prospective study, conducted on 30 cases with clinical criteria of traumatic soft tissue defects of the extremity and defects after removal of scar contracture at upper or lower limb. Results: Reconstruction was performed to 27 patients using para-scapular free flaps (90%) and the other 3 patients were reconstructed by scapular free flaps (10%). The length of the flaps ranged from 13-38 cm (mean: 27.3±3.1cm), the width of the flaps ranged from 6-12 cm (mean: 7.4±1.7 cm). The flap thickness ranged from 7-14 mm (mean 8.5±1.3 mm). The vascular pedicles length ranged from 3-5 cm (mean 4±0.6 cm). The operative time for the scapular and para-scapular free flaps was ranged from 250-550 minutes (mean: 290±39.4). Conclusions:The scapular and parascapular flaps are a multipurpose alternate in reconstructing soft tissue of the upper & lower extremities, that might be utilized for various indications in properly selected cases. These flaps should be ones of cornerstone flaps in reconstructing soft tissue defect of the upper and lower limbs reconstruction since it has numerous advantages and versatility as reliable blood supply, thin (No need for further debulking), large coverage area, and less donor-site morbidity to provide the required functional and aesthetic outcomes. Finally, the decision concerning the best method for reconstruction requiring free flaps is better to be individualized according to patient's factors as well as the experience of the surgeon.

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Section: Introductionmentioning

confidence: 99%

Versatility of scapular and parascapular free flaps in limb reconstruction

Khalifa,

Zayed,

Shalaby

et al. 2024

Int. J. Surg. Sci.

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show abstract

“…The thoracodorsal artery perforator flap has great potential for the repair of large and relatively superficial wounds in the upper extremity due to its suitable skin colour, texture, and thickness as well as its hidden donor site [ 7 ], reliable vascular pedicle [ 8 ], and ability to combine with muscle tissue to form a chimeric flap [ 9 , 10 ]. With recent research trends focusing on reducing damage and local scarring at the donor site and expanding the clinical application of thoracodorsal artery perforator flaps, we conducted a study on the use of free thoracodorsal artery polyfoliate perforator flaps to repair soft tissue defects wounds in the hand.…”

Section: Introductionmentioning

confidence: 99%

Free thoracodorsal artery polyfoliate perforator flaps for repairing multiple soft tissue defects in the hand

et al. 2021

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Background Hand injury is commonly associated with multiple soft tissue defects. Polyfoliate flaps grafting is the optimal approach for multiple wounds.The feasibility of clinical using of free thoracodorsal artery polyfoliate perforator flaps for repairing multiple soft tissue defects in the hand needs to be confirmed in clinical practice. Methods Fifteen patients with hand soft tissue defects that were repaired using free thoracodorsal artery polyfoliate perforator flaps from January 2015 to February 2018 was retrospectively analysed. The survival rate, the operative time, the appearance and sensory recovery of the flaps, and hand function were evaluated. Results The flaps of all 15 patients survived. Vascular crisis occurred in one patient, and the flap was saved after exploratory operation. The 15 patients were followed up for 12–26 months. Sensation in the flaps was partially recovered in all 15 patients. The wound in the donor area was closed directly with sutures. Mean score of scars at the donor site were assessed using the modified Vancouver scar scale (VSS) was 2.7. A puffed appearance in the recipient area was noted in four patients. To obtain a more satisfactory appearance, revision of the flap was performed once in these four patients. The Total Active Movement (TAM) evaluation system was used to assess the results, which were considered excellent in seven patients, good in six patients, fair in two patients, and poor in none of the patients. Ten of the 15 patients returned to their primary jobs. Conclusion Free thoracodorsal artery polyfoliate perforator flaps are appropriate for repairing multiple soft tissue defects in the hand, offer a satisfactory appearance, require a short operative time, and have little impact on the function and aesthetics of the donor site.

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“…The thoracodorsal artery perforator ap has great potential for the repair of large and relatively super cial wounds in the upper extremity due to its suitable skin colour, texture, and thickness as well as its hidden donor site(6, 7), reliable vascular pedicle(8), and ability to combine with muscle tissue to form a chimeric ap (9,10). With recent research trends focusing on reducing damage and local scarring at the donor site and expanding the clinical application of thoracodorsal artery perforator aps, we conducted a study on the use of free thoracodorsal artery polyfoliate perforator aps to repair soft tissue defects wounds in the hand.…”

Section: Introductionmentioning

confidence: 99%

Free Thoracodorsal Artery Polyfoliate Perforator Flaps for Repairing Multiple Soft Tissue Defects in the Hand

Ding

Xue

Zhou

et al. 2021

Preprint

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Background: Hand injury is commonly associated with multiple soft tissue defects. Polyfoliate flaps grafting is the optimal approach for multiple wounds.To confirm the feasibility of clinical using of free thoracodorsal artery polyfoliate perforator flaps for repairing multiple soft tissue defects in the hand. Methods: Fifteen patients with hand soft tissue defects that were repaired using free thoracodorsal artery polyfoliate perforator flaps from January 2015 to February 2018 was retrospectively analysed. The survival rate, the operative time, the appearance and sensory recovery of the flaps, and hand function were evaluated. Results: The flaps of all 15 patients survived. Vascular crisis occurred in one patient, and the flap was saved after exploratory operation. The 15 patients were followed up for 12-26 months. Sensation in the flaps was partially recovered in all 15 patients. The wound in the donor area was closed directly with sutures. Obvious scar hyperplasia was noted in three patients. A puffed appearance in the recipient area was noted in four patients.To obtain a more satisfactory appearance, revision of the flap was performed once in these four patients. The Total Active Movement (TAM) evaluation system was used to assess the results, which were considered excellent in seven patients, good in six patients, fair in two patients, and poor in none of the patients. Ten of the 15 patients returned to their primary jobs. Conclusion: Free thoracodorsal artery polyfoliate perforator flaps are appropriate for repairing multiple soft tissue defects in the hand, offer a satisfactory appearance, require a short operative time, and have little impact on the function and aesthetics of the donor site.

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Clinical Applications of the Thoracodorsal Artery Perforator Flap in Extremity Soft Tissue Reconstruction

Cited by 3 publications

References 19 publications

Versatility of scapular and parascapular free flaps in limb reconstruction

Versatility of scapular and parascapular free flaps in limb reconstruction

Free thoracodorsal artery polyfoliate perforator flaps for repairing multiple soft tissue defects in the hand

Free Thoracodorsal Artery Polyfoliate Perforator Flaps for Repairing Multiple Soft Tissue Defects in the Hand

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