Lateral Thoracodorsal Flap or Lateral Intercostal Artery Perforator Flap

Sjöberg, Thomas; Weerd, Louis de

doi:10.1097/sap.0000000000000978

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…The LICAP flap has the same blood supply but it is harvested via a microsurgical perforator dissection and it should not include the underlying muscular fascia. 18 These 3 flaps (LTAP, LTD, and LICAP) have the advantage of preserving the thoracodorsal pedicle without sacrificing the skin paddle of the LD musculocutaneous flap in a scenario of unknown oncological margins. The aim of this article was to provide a review of the literature regarding the use of the LTAP flap, the LTD flap, and the LICAP flap for treating lateral partial breast defects.…”

Section: Introductionmentioning

confidence: 99%

Breast Reconstruction Using the Lateral Thoracic, Thoracodorsal, and Intercostal Arteries Perforator Flaps

Mangialardi

Baldelli

Salgarello

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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Background: Breast-conserving surgery followed by radiotherapy represents the standard of care for early-stage breast cancer. The aim of this article was to provide a review of the literature about the use of the lateral thoracic artery perforator (LTAP) flap, the lateral thoracodorsal (LTD) flap, and the lateral intercostal artery perforator (LICAP) flap in lateral partial breast defect. Methods: A literature search was performed via PubMed, Medline, and Cochrane. Patient’s characteristics, topography and size of breast defect, flap size and design, number of perforators, and operative time were analyzed. Aesthetic and patient-reported outcomes, postoperative complications, and donor site morbidity were also registered. Results: Thirteen articles fulfilled inclusion criteria, and 432 patients were included. Different flap designs and flap combinations were described. Satisfactory outcomes were reported for between 78% and 100% of cases. Patient satisfaction ranged from 75.8% to 92.5% of cases. The overall complication rate was 9.25%, and donor site morbidity was very low (3.7%). Conclusions: A distinct advantage of LTAP, LTD, and LICAP flap reconstruction is that the thoracodorsal pedicle is not sacrificed, not compromising eventual delayed breast reconstruction with TDAP or latissimus dorsi flaps. This staged approach to partial breast reconstruction is especially useful in cases where the oncological margins are uncertain and wider resections (or mastectomies) are secondly required.

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Section: Introductionmentioning

confidence: 99%

Breast Reconstruction Using the Lateral Thoracic, Thoracodorsal, and Intercostal Arteries Perforator Flaps

Mangialardi

Baldelli

Salgarello

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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“…8,16 This group of flaps include the lateral thoracic artery perforator flap, the lateral thoracodorsal flap, the lateral intercostal artery perforator (LICAP) flap, or the thoracodorsal perforator flap. [17][18][19][20][21][22] These flaps are available in most patients and can be used to fill most defects of the superior, lateral, and inferior breast. Importantly, they are described with minimal donor site morbidity and the ability to maintain the blood supply to the latissimus dorsi for future reconstruction if needed.…”

Section: Introductionmentioning

confidence: 99%

The Versatility of Lateral Chest Wall Perforator Flaps in Immediate and Delayed Breast Reconstruction: Retrospective Study of Clinical Experience with 26 Patients

et al. 2021

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Rationale: Lateral chest flaps represent versatile reconstructive options, especially valuable in times of global healthcare resource restriction. In this series, we present our experience with the use of lateral chest wall flaps in both immediate and delayed reconstruction from both breast conserving and mastectomy surgery. Methods: A retrospective cohort study of patients who had undergone a lateral chest wall flap for immediate or delayed breast reconstruction of a lumpectomy or mastectomy defect was performed. Data collected consisted of patient demographics, procedure type, tumor/oncological characteristics, as well as postoperative complications. Findings: Between September 2015 and April 2021, 26 patients underwent breast reconstruction using a lateral chest wall flap. Fifteen patients (58%) underwent immediate reconstruction (9 lumpectomy; 6 mastectomy) and 11 (42%) underwent delayed breast reconstruction. All flaps survived, though 1 patient required partial flap debridement following venous compromise hours after surgery. There were no incidences of hematoma, seroma, infection, or wound healing delay at either the donor site or breast. There was one positive margin which occurred in a mastectomy patient. Significance: This study describes the use of lateral chest wall flaps in a wide variety of reconstructive breast surgery scenarios. This technique can be safely performed in an outpatient setting and does not require microvascular techniques. Review of our outcomes and complications demonstrate that this is a safe and effective option. Our experience is that this is an easy to learn, versatile flap that could be a valuable addition to the surgeon's arsenal in breast reconstruction.

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“… 2 – 6 In accordance with the recent change in flap nomenclature, the pedicled LTD flap should now more correctly be named the pedicled lateral intercostal artery perforator (LICAP) flap. 7 , 8 …”

Section: Introductionmentioning

confidence: 99%

The Pedicled LICAP Flap Combined with a Free Abdominal Flap In Autologous Breast Reconstructions

Sjöberg

Weerd

2018

Plastic and Reconstructive Surgery - Global Open

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Background:Previous surgery or slim body configuration can limit the size of the available abdominal flap in autologous breast reconstruction. However, redundant skin and subcutaneous tissue lateral to the mastectomy site can be utilized as the pedicled lateral intercostal artery perforator (LICAP) flap. This study evaluates the combination of a free abdominal flap and a pedicled LICAP flap to achieve increased breast size and improved cosmetic outcome.Methods:Patients undergoing secondary autologous breast reconstruction were included in a prospective study. The combination with a LICAP flap was used for women with insufficient abdominal flap tissue in relation to the desired breast size. The authors also assessed their modification of the original lateral thoracodorsal flap design to improve the aesthetic outcome.Results:In 109 patients, 121 free abdominal flaps were performed. The combination with a pedicled LICAP flap was used in 82 free abdominal flap reconstructions (68%). The LICAP flap provided additional volume and resulted in better projection and ptosis of the neo-mamma. The overall complication rate for the LICAP flaps was 26 %; all minor complications. Despite combining flaps, the majority of patients needed additional surgery to improve breast symmetry. Breast reduction of the native breast was the most common symmetrizing procedure.Conclusion:In selected patients with insufficient abdominal flap tissue, a combination of a free abdominal flap and a pedicled LICAP flap is a valuable option to increase breast size and cosmetic outcome. Additional symmetrizing surgery might still be necessary.

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Lateral Thoracodorsal Flap or Lateral Intercostal Artery Perforator Flap

Cited by 3 publications

References 9 publications

Breast Reconstruction Using the Lateral Thoracic, Thoracodorsal, and Intercostal Arteries Perforator Flaps

Breast Reconstruction Using the Lateral Thoracic, Thoracodorsal, and Intercostal Arteries Perforator Flaps

The Versatility of Lateral Chest Wall Perforator Flaps in Immediate and Delayed Breast Reconstruction: Retrospective Study of Clinical Experience with 26 Patients

The Pedicled LICAP Flap Combined with a Free Abdominal Flap In Autologous Breast Reconstructions

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