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[The thoracodorsal artery perforator flap]
A H Schwabegger1, G Bodner, M Ninković
1Universitätsklinik für Plastische und Wiederherstellungschirurgie, Ludwig-Boltzmann-Institut für Qualitätskontrolle in der Plastischen Chirurgie, Innsbruck, Osterreich, Germany. anton.schwabegger@uibk.ac.at
Handchirurgie, Mikrochirurgie, Plastische Chirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Handchirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Mikrochirurgie Der Peripheren Nerven Und Gefasse : Organ Der V
|December 20, 2002
Summary
The thoracodorsal artery perforator flap requires significant surgical skill. While successful as a free flap, its use as an island flap has a high failure rate, limiting its application.
Area of Science:
- Microsurgery
- Plastic Surgery
- Reconstructive Surgery
Context:
- The thoracodorsal artery perforator flap is a recently described flap with limited available literature.
- Its application, particularly as an island flap, requires a high level of surgical expertise.
Purpose:
- To critically evaluate the use and potential pitfalls of the thoracodorsal artery perforator flap.
- To assess the flap's success rates when used as both an island flap and a free flap.
Summary:
- The thoracodorsal artery perforator flap was used 12 times: twice as an island flap (both failed) and ten times as a free flap (one failure).
- Harvesting involves delicate transmuscular vessel preparation, and island transposition has limited range.
- Preoperative color Doppler imaging and microsurgical expertise are crucial for successful perforator identification and flap elevation.
Impact:
- The flap is recommended only for carefully selected cases by experienced microsurgeons.
- Its use is justified when a long vascular pedicle is needed for free tissue transfer, prioritizing aesthetics and minimizing donor-site morbidity over a potentially higher failure rate.