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Published on: August 1, 2022
Use of thoracodorsal artery perforator flap for soft tissue reconstruction in children
Seong Eon Kim1, In Hyeok Rhyou, Bo Gun Suh
1Department of Plastic and Reconstructive Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI 48109-0340, USA.
Insights
Perforator free flaps (PFFs) offer thinner reconstruction with less donor-site morbidity. This study demonstrates the successful use of thoracodorsal artery perforator flaps in pediatric soft tissue reconstruction, challenging previous concerns.
Area of Science:
- Plastic Surgery
- Pediatric Surgery
- Microsurgery
Background:
- Perforator free flaps (PFFs) are increasingly used for adult soft tissue reconstruction due to their thin profile and reduced donor-site morbidity.
- However, their application in pediatric patients is limited by concerns regarding the smaller caliber of perforator vessels and perceived higher failure rates.
Observation:
- This study presents a series of 4 consecutive pediatric cases utilizing the thoracodorsal artery perforator flap for soft tissue reconstruction.
- The cases highlight the successful application of this specific PFF technique in children.
Findings:
- The thoracodorsal artery perforator flap was successfully transferred in all 4 pediatric cases, demonstrating its viability and effectiveness.
- The flap design and surgical technique employed were crucial for achieving successful outcomes in these young patients.
Implications:
- The findings suggest that PFFs, specifically the thoracodorsal artery perforator flap, can be safely and effectively used in pediatric soft tissue reconstruction.
- This challenges the prevailing hesitation among surgeons and may expand reconstructive options for children with soft tissue defects.
Abstract:
Perforator free flap (PFF) is now performed with increasing frequency for soft tissue reconstruction in adults. When compared with conventional free skin flaps, PFFs are thinner and have less donor-site morbidity because only the skin is harvested. The advancement of the PFF design has spurred the identification of many skin flaps based on the perforator principle. Although PFFs are used in adults, most reconstructive surgeons still hesitate to perform PFFs in children. The main cause of concern is the perceived high failure rate related to the small diameter of children's perforator vessels. We present 4 consecutive cases of successful transfer of thoracodorsal artery perforator flap in children. We present our flap design and surgical technique to highlight the usefulness of this flap for reconstructing soft tissue defects in children.
