Thoracodorsal Artery Perforator Flap Anterograde Dissection: From Source Vessel to Perforator

Scafati, Salvatore Taglialatela; Cavaliere, Annachiara; D’Andrea, Francesco; Schönauer, Fabrizio

doi:10.1097/gox.0000000000003390

Cited by 1 publication

(1 citation statement)

References 5 publications

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“… Application of a TDAP (Thoracodorsal artery perforator flap): If the thoracodorsal flap perforator was chosen, the anterior boundary was at the lateral margin of the pectoralis major muscle, the posterior boundary was at the anterior edge of the latissimus dorsi muscle, the upper boundary was at the thoracodorsal vessel bifurcation of the axillary vessels, and the lower boundary could reach the umbilical level due to sufficient bare perforations of the thoracic dorsal artery branch [ 8 ]. This flap could be designed to have a more extensive range of motion than other regional flaps.…”

Section: Operation Processmentioning

confidence: 99%

Partial breast reconstruction of 30 cases with peri-mammary artery perforator flaps

Shen

Wu³

et al. 2023

BMC Surg

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Background Volume replacement is one of the vital techniques of oncoplastic surgery (OPS) when applying breast-conserving surgery. The clinical application of peri-mammary artery perforator flaps for this indication is uneven in China. Here, we describe the results of our clinical experience with peri-mammary artery flaps for partial breast reconstruction. Methods In this study, 30 patients underwent partial breast resection for quadrant breast cancer followed by partial breast reconstruction with peri-mammary artery perforator flaps, which included the thoracodorsal artery perforator flap (TDAP), anterior intercostal artery perforator flap (AICAP), lateral intercostal artery perforator flap (LICAP), and lateral thoracic artery perforator flap (LTAP). All the patients’ operation plans were discussed comprehensively and were performed by sticking to every step. The satisfaction outcome was assessed with the extracted version of the BREAST-Q version 2.0, Breast Conserving Therapy Module Preoperative and Postoperative Scales both preoperatively and postoperatively. Results According to the study outcomes, the mean flap size was 5.3*4.2*2.8 cm (3.0–7.0*3.0–5.0*1.0–3.5 cm). The mean surgical time was 142 min (100–250 min). No partial flap failure was detected, and no severe complications were observed. Most patients were satisfied with the outcomes regarding the dressing, sexual life, and breast shape postoperation. Furthermore, the sensation of the surgical area, scar satisfaction, and recovery state gradually improved. Overall, LICAP and AICAP had higher scores when different flaps were compared. Conclusions Based on this study, we found that peri-mammary artery flaps had significant value in breast-conserving surgery, especially in patients with small or medium-sized breasts. Perforators could be detected by vascular ultrasound before the operation. More than one perforator could be found most of the time. No severe complications occurred when performing a suitable plan, including discussing and recording the operation procedure; the focus of care, the choice for precise and proper perforators, and the mechanism for hiding the scars were all considered and recorded in a specific chart. Patients were satisfied with the reconstruction technique of peri-mammary artery perforator flaps after breast-conserving, and the satisfaction of AICAP and LICAP was higher. In general, this technique is suitable for partial breast reconstruction and has no negative impact on patient satisfaction.

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Section: Operation Processmentioning

confidence: 99%