TDAP: Island versus propeller

Angrigiani, Claudio; Rancati, Alberto; Artero, Guillermo; Escudero, Ezequiel; Khouri, Roger K.

doi:10.1016/j.bjps.2015.11.009

Cited by 9 publications

(4 citation statements)

References 15 publications

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“…The TDA procedures and selection between these procedures can be performed without CDU. However, the surgeon should be prepared to change the type of procedure on the fly [16,18,23]. As always the surgeon should know and rely on common anatomy [7,16,18].…”

Section: Discussionmentioning

confidence: 99%

“…We achieved the planned breast reconstruction in 459 of 491 cases (93%). We have not included details about flap size, aesthetic outcomes, or complications of the individual flap types in this review, as the majority of our data have been published previously, for the classic TDAP flap [7,16,23], the propeller TDAP flap [10][11][12][13][18][19][20][23][24][25], LD flaps [7,19,20,24,26], and the stacked TDAP flap [27].…”

Section: Our Experience Using Tda Flap Breast Reconstructionsmentioning

confidence: 99%

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Thoracodorsal artery flaps for breast reconstruction–the variants and its approach

et al. 2021

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Thoracodorsal artery (TDA) flaps, ranging from the vascular-pedicled thoracodorsal artery perforator (TDAP) flap, the propeller TDAP flap, and the muscle-sparing latissimus dorsi (MSLD) flap to the conventional latissimus dorsi (LD) flap and the extended LD flap, can all be used for breast reconstruction. The aim of this paper and review is to share our experiences and recommendations for procedure selection when applying TDA-based flaps for breast reconstruction. We describe the different surgical techniques and our thoughts and experience regarding indications and selection between these procedures for individual patients who opt for breast reconstruction. We have performed 574 TDA flaps in 491 patients: 60 extended LD flaps, 122 conventional LD flaps, two MSLD flaps, 233 propeller TDAP flaps, 122 TDAP flaps, and 35 free contralateral TDAP flaps for stacked TDAP breast reconstruction. All the TDA flaps are important flaps for reconstruction of the breast. The LD flap is still an option, although we prefer flaps without muscle when possible. The vascular-pedicled TDAP flap is an option for experienced surgeons, and the propeller TDAP flap can be used in most reconstructive cases of the breast, although a secondary procedure is often necessary for correction of the pedicle bulk. The extended LD flap is an option for women with a substantial body mass index, although it is associated with the highest morbidity of all the TDA flaps. The MSLD flap can be used if the perforators are small or if dissection of the perforators is assessed to be hazardous.

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Section: Discussionmentioning

confidence: 99%

Section: Our Experience Using Tda Flap Breast Reconstructionsmentioning

confidence: 99%

Thoracodorsal artery flaps for breast reconstruction–the variants and its approach

et al. 2021

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“…In fact, except for one article that excluded a patient with tumor location in the upper inner quadrant, all authors agreed that the TDAP flap can safely reach every breast quadrant. Angrigiani et al 34 , 35 compared the differences in the “reaching distances” between propeller and island TDAP flaps. This study reported that the propeller TDAP flap is easier to harvest, which reduces operating time by approximately 30 minutes, but has about an 8.4 cm shorter reach in comparison with the island TDAP flap.…”

Section: Discussionmentioning

confidence: 99%

“…This study reported that the propeller TDAP flap is easier to harvest, which reduces operating time by approximately 30 minutes, but has about an 8.4 cm shorter reach in comparison with the island TDAP flap. 35 This limit is crucial when the breast defect is located in the inner quadrants. Converting the propeller flap into a conventional island TDAP flap and dissecting the pedicle until its origin allows for the maximization of the flap-reaching distance, making volume replacement possible in upper and lower inner quadrants.…”

Section: Discussionmentioning

confidence: 99%

Thoracodorsal Artery Perforator Flap in Partial Breast Reconstruction: A Systematic Review

Mangialardi

Baldelli

Salgarello

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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Introduction: Breast conserving surgery followed by radiation therapy represents the standard of care for early stage breast cancer. Oncoplastic breast surgery includes several reconstructive techniques essentially summarized in 2 categories: volume displacement and volume replacement procedures. These latest procedures have evolved over time from the use of the entire latissimus dorsi muscle to the use of pedicled perforator flaps, namely the thoracodorsal artery perforator (TDAP) flap. The aim of this article is to provide a comprehensive review of the literature regarding the use of the TDAP flap in partial breast defects. Methods: A literature search was performed via PubMed, Medline, and Cochrane. Studies reporting the use of the TDAP flap after breast conserving surgery were included. Patient characteristics, topography and size of breast defect, flap size and design, number of perforators, and operative time were analyzed. Moreover, aesthetic and functional (shoulder morbidity) results, patient satisfaction, postoperative complications, and donor site morbidity were registered. Results: Twelve articles fulfilled inclusion criteria, and 337 patients were included. All articles except 1 described the use of the TDAP flap for defects in every breast quadrant. The mean weight of resected breast tissue was 97.28 g, and patients with over 20% of volume deficiency were considered eligible for TDAP flap volume replacement. The ellipse-shaped skin paddle (oriented oblique downward, transversal or oblique upward in most cases) was extended over the anterior border of the latissimus dorsi muscle to include possible septocutaneous perforator vessels. Most authors began the dissection from the anterior and caudal border of the flap to reserve the possibility to convert the TDAP to a musculocutaneous flap and check for septocutaneous perforators. Flap size ranged from 4 × 12 to 21 × 9 cm. The mean procedure time was 192.21 minutes. Mean follow-up was 17.42 months. Evaluation by way of a 5-point Likert scale reported overall mean values of over 4 points. Satisfactory outcomes were reported in 92.85%–100% of cases. Patient satisfaction ranged from 80% to 94% of cases. The incidence of seroma (1 case) and “shoulder-related” donor site morbidity was very low. Conclusions: Despite the heterogeneity of the evaluation methods, our review suggested that the use of the TDAP flap in oncoplastic surgery allows for satisfactory aesthetic outcomes and quite high levels of patient satisfaction. The TDAP flap represents an effective and versatile tool that amplifies the oncoplastic surgeon’s arsenal, which allows for satisfactory outcomes.

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Reconstruction mammaire secondaire unilatérale par lambeau dorsal pédiculé épargnant le muscle grand dorsal (TDAP et MSLD) chez les patientes aux antécédents de mastectomie totale pour cancer du sein. Étude observationnelle monocentrique

Barbat,

Hu,

Rouanet

et al. 2024

Annales de Chirurgie Plastique Esthétique

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TDAP: Island versus propeller

Cited by 9 publications

References 15 publications

Thoracodorsal artery flaps for breast reconstruction–the variants and its approach

Thoracodorsal artery flaps for breast reconstruction–the variants and its approach

Thoracodorsal Artery Perforator Flap in Partial Breast Reconstruction: A Systematic Review

Reconstruction mammaire secondaire unilatérale par lambeau dorsal pédiculé épargnant le muscle grand dorsal (TDAP et MSLD) chez les patientes aux antécédents de mastectomie totale pour cancer du sein. Étude observationnelle monocentrique

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