The combined transverse upper gracilis and profunda artery perforator (TUGPAP) flap for breast reconstruction

Ciudad, Pedro; Maruccia, Michele; Orfaniotis, Georgios; Weng, Hui-Ching; Constantinescu, Thomas; Nicoli, Fabio; Cigna, Emanuele; Socas, Juan; Sirimahachaiyakul, Pornthep; Sapountzis, Stamatis; Kiranantawat, Kidakorn; Lin, San‐Yih; Wang, Gou‐Jen; Chen, Hung-Chi

doi:10.1002/micr.22459

Cited by 42 publications

(37 citation statements)

References 35 publications

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“…However, in their report, the sizes of the resulting skin paddles were similar to those harvested with their standard method. On the other hand, in our previous report, we showed that it was possible to obtain flaps as large as 30 × 9 cm with our TUGPAP technique, which allowed us to reconstruct moderate size breasts without major complications in addition to having low donor site morbidity (Ciudad et al, ). One important technical point to keep in mind is not to exceed 9 cm in width to avoid difficulties in donor site wound closure.…”

Section: Discussionmentioning

confidence: 82%

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Expanding the applications of the combined transverse upper gracilis and profunda artery perforator (TUGPAP) flap for extensive defects

et al. 2018

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Background The medial thigh is a well‐hidden area. The two most common flaps from this area are the transverse upper gracilis (TUG) and profunda artery perforator (PAP) flaps. Herein, we explored the applications of combined TUGPAP flap to reconstruct large and complex defects in different regions. Methods Between November 2015 and May 2017, 28 patients who underwent reconstruction and extensive soft tissue coverage with the TUGPAP flap for the breasts, head and neck, and pelvi‐perineal regions were included. The defects size ranged from 22 to 29 × 6–8 cm. All flaps were based on the two pedicles: the medial circumflex femoral artery for TUG flap and the profunda artery perforator for PAP flap. They were each anastomosed to a set of recipient vessels. A “Y”‐shaped interposition vein graft (YVG) was used if only one recipient artery was available. Results The harvested skin paddle had dimensions ranged from 20 to 30 × 6–9 cm and all flaps survived completely. Postoperative complications included one case each of donor and recipient site seroma, and one case of wound dehiscence. They were all successfully managed conservatively. During an average follow‐up period of 12.7 months, one patient reported permanent paresthesia in the donor site and another developed hypertrophic scar. All patients were able to resume daily activity without major concerns. Conclusion The combined TUGPAP flap is a safe, effective, and a good alternative to the common workhorse flaps as it offers the potential for a large skin paddle and decent soft tissue volume with low donor site morbidity in a well‐concealed area.

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Section: Discussionmentioning

confidence: 82%

“…proximity of both flaps, the TUG and PAP flaps can be harvested together to increase tissue volume and reliability. The TUGPAP flap has been described for reconstructions of the breast and pelviperineal regions that required larger tissue volume and skin coverage (Ciudad et al, 2015(Ciudad et al, , 2016(Ciudad et al, , 2017.…”

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confidence: 99%

Expanding the applications of the combined transverse upper gracilis and profunda artery perforator (TUGPAP) flap for extensive defects

et al. 2018

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“…L'indice de masse corporel moyen (IMC) était de 23,7 (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)5). Dix-sept patientes (57 %) ont eu de la radiothérapie en préopératoire.…”

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Reconstruction mammaire par profunda artery perforator flap : étude prospective des 30 premiers cas consécutifs

Haddad¹,

Hunsinger²,

Obadia³

et al. 2016

Annales de Chirurgie Plastique Esthétique

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“…Several methods have been proposed for columellar reconstruction, which mainly range from composite grafting to local flap transfer (Ciudad et al, ; Ciudad, Maruccia, Sapountzis, & Chen, ; Dessy, Marcasciano, Fanelli, Mazzocchi, & Ribuffo, ; Giudice & Vestita, ; Nicoli et al, ; Sherris, Fuerstenberg, Danahey, & Hilger, ; Smith & Papay, ). Although relatively easy to perform technically, composite grafts are restricted by problems such as viability, dimensions, and atrophy (Millard, ), while the main limitation of the transferring nearby tissue in case of acquired columellar defects is that the columellar deformity is usually combined with other nasal subunit deficiency and local tissues become not suitable (Liu, Xu, Wang, Dong, & Dai, ).…”

Section: Introductionmentioning

confidence: 99%

Microsurgical reconstruction of the isolated columellar defect with a prelaminated radial forearm free flap. A case report and a review of the literature

2019

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The columella is one of the smallest subunits of the nose, but the loss of this structure has important aesthetic and structural implications. Few papers in literature present microsurgical techniques for the reconstruction of an isolated columellar defect. This report describes the use of a prelaminated radial forearm free flap (RFFF) for the reconstruction of an isolated columellar defect and reviews the current literature. A 45‐year‐old woman presented to our Unit with a history of palate squamous cell carcinoma and severe nasal deformity with an almost complete loss of the columella. A prelaminated RFFF with the fifth rib was used for a two‐staged reconstruction of the isolated columellar defect. The radial pedicle was anastomosed to the facial vessels and the postoperative course was uneventful. Complete survival of the flap was achieved and, 10 months postoperatively, the patient had bilateral nasal patency, with an increased tip projection and a good aesthetic result. A prelaminated RFFF can be considered a valuable reconstructive option in cases of a large composite defect of the columella and limited availability of adjacent tissues.

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The combined transverse upper gracilis and profunda artery perforator (TUGPAP) flap for breast reconstruction

Abstract: With appropriate patient selection and surgical technique the TUGPAP flap could be a valuable option as an alternative method for autologous breast reconstruction. © 2015 Wiley Periodicals, Inc. Microsurgery, 2015.

Cited by 42 publications

References 35 publications

Expanding the applications of the combined transverse upper gracilis and profunda artery perforator (TUGPAP) flap for extensive defects

Expanding the applications of the combined transverse upper gracilis and profunda artery perforator (TUGPAP) flap for extensive defects

Reconstruction mammaire par profunda artery perforator flap : étude prospective des 30 premiers cas consécutifs

Microsurgical reconstruction of the isolated columellar defect with a prelaminated radial forearm free flap. A case report and a review of the literature

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