The versatility of the islanded posterior arm flap for regional reconstruction around the axilla

Schmidt, Manfred; Dunst-Huemer, Karin M.; Lazzeri, Davide; Schoeffl, Harald; Huemer, Georg M.

doi:10.1016/j.bjps.2015.03.002

Cited by 25 publications

(24 citation statements)

References 18 publications

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“…Secondary healing is less desirable as it may cause contractures and subsequent limitation in the arm's range of movement leading to stiffening of the shoulders [15]. Commonly cited primary closure methods for axillary HS include the use of direct closure, split thickness skin graft (STSG), fasciocutaneous flap, musculocutaneous flap, parascapular flap, thoracodorsal artery perforator flap (TDAP) and posterior-arm flap [612161718]. A further innovative method for reconstruction has been introduced over the last few years with the addition of the inner-arm flap [19].…”

Section: Discussionmentioning

confidence: 99%

Axillary Reconstruction for Hidradenitis Suppurativa with an Inner-Arm Transposition Flap Creating a Brachioplasty Effect

et al. 2017

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BackgroundHidradenitis suppurativa (HS) is a chronic skin condition that can affect any area with apocrine sweat glands and has the potential to involve multiple sites concurrently. Commonly affected sites include the axilla, groin, perineum and perianal areas. In this study we performed a literature review on the surgical methods for HS and describe an innovative technique for reconstructing axilla HS using an inner-arm transposition flap.MethodsWe reviewed all cases (5 cases from 4 patients) of transposition flap reconstruction performed by the senior author at a single London tertiary hospital from 2008–2013. Patient related outcome measures were collected using the Derriford appearance scale (DAS 24) and a study specific questionnaire.ResultsAll patients were satisfied with their final result. One out of five cases had a complication but did not result in flap failure. There is no disease recurrence to date. DAS 24 scores collected demonstrated acceptable postoperative distress that did not deviate far from the norm tables while study specific questionnaire reveal desirable outcomes.ConclusionsWe have managed to achieve our aim through the use of the innovative inner-arm transposition flap. Our study hopes to provide an additional technique for axillary reconstruction. This technique offers the effective concealment of scars with the benefit of tightening of the arm tissue producing ‘brachioplasty like’ effects. All things considered it would be reasonable to conclude the innovative flap technique is a reliable, effective, and simple method that results in multiple benefits.

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Section: Discussionmentioning

confidence: 99%

Axillary Reconstruction for Hidradenitis Suppurativa with an Inner-Arm Transposition Flap Creating a Brachioplasty Effect

et al. 2017

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“…Ohne die Möglichkeit zur Defektrekonstruktion durch den Einsatz eines LTAP-Lappens in Propellertechnik wäre sonst die Restdefektrekonstruktion durch eine weitere regionale Lappenplastik wie z. B. durch einen posterioren Oberarmlappen notwendig [22]. Hiermit wäre eine deutlich höhere Hebemorbidität durch die Anwendung von mehreren Lappenplastiken verbunden.…”

Section: Vy-lappens Um Die Perforatorlage Zentriert Bei Hohen Bis Iunclassified

Die Verwendung lokaler Perforatorlappenplastiken der Arteria thoracica lateralis (LTAP) und Arteria thoracodorsalis (TDAP) zur axillären Rekonstruktion bei Hidradenitis suppurativa

Dietrich¹,

Reumuth²,

Kuentscher³

et al. 2020

Handchir Mikrochir Plast Chir.

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ZusammenfassungDie Hidradenitis suppurativa ist eine chronisch entzündliche Erkrankung von Terminalfollikeln und apokrinen Drüsen der Axilla. Die sichere und kosmetisch ansprechende Rekonstruktion großer Defekte nach radikaler Exzision erkrankter Areale in der Axilla stellt eine operative Herausforderung an den Chirurgen dar. Die laterale Thoraxregion bietet – neben weiteren – die Möglichkeit zur lokalen Perforatorlappenplastik, basierend auf der Arteria thoracodorsalis und der Arteria thoracica lateralis. Diese Arbeit zeigt erstmals in großer Fallzahl die Rekonstruktion axillärer Defekte durch den lateral thoracic artery perforator-Lappen. Insgesamt 13 Lappenplastiken (10 lateral thoracic artery perforator-Lappen und 3 thoracodorsal artery perforator-Lappen) wurden eingeschlossen. Die Patienten wurden im Rahmen der Nachuntersuchung auf postoperative Komplikationen nach Clavien-Dindo, das subjektive kosmetische Ergebnis, die Abduktionsfähigkeit des Arms in Form der range of motion und auf die Rezidivrate hin untersucht. Hierbei kam es weder zu einem Lappenuntergang noch zu einer Lappenteilnekrose. Bis auf einen Fall bewerteten alle Patienten das kosmetische Ergebnis als sehr gut oder gut. Die postoperative Schulterbeweglichkeit war stets uneingeschränkt mit einer maximalen Abduktionsfähigkeit von 178,8 ± 4,2° und in der postoperativen Nachuntersuchung von durchschnittlich 27,2 ± 14,4 Monaten kam es in keinem Fall zu einem Rezidiv. Die Verwendung der lokalen fasziokutanen Perforatorlappen der Arteria thoracica lateralis und Arteria thoracodorsalis zur plastisch-chirurgischen Behandlung der axillären HS im Stadium II und III führt zu guten ästhetischen und funktionellen Ergebnissen.

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“…In one study of 35 flaps, the average flap dimension was 8 cm × 12 cm. 18 An obvious downside of this reconstruction is the ensuing scar and deformity that results at the donor site on the arm, which is visible with short sleeve shirts as opposed to other types of reconstruction. Although this flap is suitable in a limited number of situations, it is nonetheless helpful to bear in mind.…”

Section: Introductionmentioning

confidence: 99%

Review of Procedures for Reconstruction of Soft Tissue Chest Wall Defects Following Advanced Breast Malignancies

et al. 2019

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The purpose of this article is to review closure options for complex chest wounds in patients with locally advanced breast cancer. Experiences of the plastic and oncologic surgery teams at Moffitt Cancer Center were reviewed, and the literature researched for various surgical options of complex chest wound closure. Multiple treatment modalities exist for reconstruction of complex chest wall wounds with the external oblique and V-Y latissimus dorsi musculocutaneous advancement flaps serving as workhorses in reconstruction. Treatment of cancer has moved from simply a surgical solution to include other modalities such as hormonal therapy, chemotherapy, and radiation—the latter 2 having serious consequences for wound healing. A team approach and knowledge of available flap options are vital for closure of complex wounds in a timely manner. Appropriate planning can optimize the primary goal of the oncologic surgeon to remove the cancer and the plastic surgeon’s objective to reconstruct the defect and achieve a closed, durable wound prior to chemotherapy and radiation. We present the experience at the Moffitt Cancer Center in reconstructing challenging chest defects and review the reconstructive ladder.

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The versatility of the islanded posterior arm flap for regional reconstruction around the axilla

Cited by 25 publications

References 18 publications

Axillary Reconstruction for Hidradenitis Suppurativa with an Inner-Arm Transposition Flap Creating a Brachioplasty Effect

Axillary Reconstruction for Hidradenitis Suppurativa with an Inner-Arm Transposition Flap Creating a Brachioplasty Effect

Die Verwendung lokaler Perforatorlappenplastiken der Arteria thoracica lateralis (LTAP) und Arteria thoracodorsalis (TDAP) zur axillären Rekonstruktion bei Hidradenitis suppurativa

Review of Procedures for Reconstruction of Soft Tissue Chest Wall Defects Following Advanced Breast Malignancies

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