Reliability of eccentric position of the pedicle instead of central position in a thoracodorsal artery perforator flap

Kim, Youn Hwan; Lee, Han Earl; Lee, Jang Hyun; Kim, Jeong Tae; Kim, Sang Wha

doi:10.1002/micr.30004

Cited by 11 publications

(15 citation statements)

References 36 publications

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“…To our knowledge, this is the first report concerning eccentrical located perforators in the PLLP flap for microsurgical reconstruction. The same method has been reported in the thoracodorsal artery perforator flap with successful reconstruction for lesions in the lower leg (Kim et al, 2017).…”

Section: Discussionmentioning

confidence: 78%

Eccentric free muscular perforator flaps in the proximal lateral leg for hand and foot reconstruction

Yen

Liu

et al. 2021

Microsurgery

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Background We aimed to introduce our modifications by using eccentrically located muscular perforators to shorten the distance between the recipient vessels and the flap pedicle for overcoming the “short pedicle” drawback of the proximal lateral leg perforator (PLLP) flap. Patients and methods A retrospective review of 12 cases undergoing free PLLP flap for hand and foot regions reconstruction during 2010 and 2019. The mean age was 43.3 years. Most defects resulted from burn and trauma injuries. The dimensions of defects ranged from 8 × 1.5 cm2 to 12 × 6.5 cm2. Muscular perforators were designed eccentrically 1–3 cm away from the central point of the flap to shorten the distance between the recipient vessels and the pedicle. The flap was designed to be 0.5–1 cm larger than the defect. Results The flap size ranged from 9 × 2 cm2 to 15 × 6 cm2. All pedicles were long enough to ensure an appropriate anastomosis without tension. The post‐operative course in all cases was uneventful. All flaps survived without complications. Primary repair of the donor sites was performed in all patients. Donor leg function was not hampered by flap harvesting. All patients were satisfied with the scar after at least 1 year of follow‐up. Conclusion Based on our experience, selection of the eccentric locations of the musculo‐cutaneous perforators were effective methods to overcome the short pedicle length of this flap type. Using our modifications, thin PLLP flaps can be used in foot and hand reconstruction with minimal donor site morbidity and a high success rate.

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Section: Discussionmentioning

confidence: 78%

Eccentric free muscular perforator flaps in the proximal lateral leg for hand and foot reconstruction

Yen

Liu

et al. 2021

Microsurgery

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“…Only one perforator was used, not only to lengthen the vascular pedicle but also because of the choice of flap setting. Perforators that are located beside the flap, rather than centrally within it, can increase the length of the vascular pedicle by up to 4–5 cm (Kim, Kim, Kim, ; Kim, Lee, Lee, Kim, & Kim, ).…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of severe atherosclerotic and obstructive diabetic feet using thoracodorsal artery perforator flaps with long vascular pedicles

2017

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“…Flap dimensions varied according to defect. The perforator does not need to be centered to reliably perfuse this flap as eccentric position of the perforator in the flap is quite safe and ensures a longer pedicle [9].…”

Section: Methodsmentioning

confidence: 99%

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

Hantash

Ayad²,

Hendy

et al. 2020

The Egyptian Journal of Plastic and Reconstructive Surgery

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Introduction: For a long time, the free or pedicled thoracodorsal artery perforator (TDAP) flaps were used for reconstruction of large cutaneous defects. These may be regional soft tissue defects of trunk, axilla and breast where the pedicled flap used, or distant tissue defects of face, elbow, forearm and lower extremity where the free TDAP flap is used. Aim of the Study: This study aimed to evaluate the clinical applications of the thoracodorsal artery perforator flap (TDAP) either free or pedicled in the reconstruction of soft tissue defects of extremities. Patients and Methods: This study was conducted on 20 patients admitted to the Plastic Surgery Departments of both Tanta & Al Azhar Universities during the period from September 2015 to December 2017. These patients were presented by extremity soft tissue defects that required a flap reconstruction. Results: The results showed that the TDAP flap is a versatile and robust flap in soft tissue reconstruction of the extremities. This flap has great advantages as a long vascular pedicle; large skin paddle can be harvested, minimal donor site morbidity and thin skin paddle to resurface shallow defects. The TDAP flap showed also some drawbacks like meticulous and time-consuming dissection of the perforators, donor site scar widening. Conclusion: TDAP flap is a versatile and an excellent flap either free or pedicled for extremity soft tissue reconstruction. It should be added to the workhorse perforator flaps.

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Reliability of eccentric position of the pedicle instead of central position in a thoracodorsal artery perforator flap

Cited by 11 publications

References 36 publications

Eccentric free muscular perforator flaps in the proximal lateral leg for hand and foot reconstruction

Eccentric free muscular perforator flaps in the proximal lateral leg for hand and foot reconstruction

Reconstruction of severe atherosclerotic and obstructive diabetic feet using thoracodorsal artery perforator flaps with long vascular pedicles

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

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