Muscle electrical activity after perforator flap surgery: a pilot cohort study

Abstract

Background Perforator flaps surgery barely damages underlying muscle function, but only clinical qualitative evidences exist about muscle preservation after surgical dissection. We have employed for the first time electromyography and nerve conduction studies in evaluating the latissimus dorsi electrical muscle function after thoraco-dorsal artery perforator flap dissection in a retrospective cohort study. Methods We included ten consecutive patients requiring axillary reconstruction with thoraco-dorsal artery perforator flap, from June 2017 to June 2018. All patients were suffering from hidradenitis suppurativa. Electromyography (EMG) and nerve conduction study (NCS) were conducted on each patient, both before and after the operation. Differences between pre-and postoperative amplitude and latency values were calculated. Results Postoperative signal amplitude and latency means did not differ significantly from the preoperative one. Operative time and area of excision did not correlate with changes of electrical function. Conclusions This is the first quantitative analysis performed for the evaluation of muscle electrical activity after perforator flap surgery. Perforator pedicle intra-muscular dissection does not cause any injury to the muscle fibers. TDAP flap confirms to be a safe procedure for latissimus dorsi muscle function. Level of evidence: Level III, therapeutic study.

A Retrospective Comparative Analysis of Latissimus Dorsi (LD) Flap Versus Thoracodorsal Artery Perforator (TDAP) Flap in Total Breast Reconstruction with Implants: A Pilot Study

“…3,4 As any other perforator flaps, TDAP flap has the great benefits of preserving muscle integrity and decreasing postoperative donor site seromas and shoulder-related sequelae. 5,6 In 2004, Hamdi et al reported the first four cases of partial breast reconstruction with a TDAP flap, while in 2007 Ortiz et al described the first successful experience of implant-based breast reconstruction combined with a TDAP flap.…”

Practical Guidelines for the Orthoplastic Approach: A Systematic Review of High-Quality Evidence for the Lower Extremity Trauma

“…The choice between a pedicled and a "free" microvascular ap depends on the type of the defect and on the personal surgical expertise [56,57]. In a recently published meta-analysis [54], free-aps and pedicled propeller aps did not show a signi cant difference in terms of overall failure rate (3,9% vs 2,8%, respectively) as well as the "coverage failure" rate (5.2% vs 2.9%, respectively).…”

One-Step Approach for Infections After Achilles Tendon Open Repair: The Distally Based Peroneus Brevis Muscle Flap

“…It can be argued that the use of pedicled propeller flaps 17 might be a better option compared with PB muscle flap, being less invasive and sparing the muscle. 18 Nevertheless, local fasciocutaneous flaps showed a complication rate of 25.2% in the meta-analysis performed by Bekara et al, 4 with a 3.5% of total flap loss and 10.2% of partial flap loss.…”