Thoracodorsal artery perforator flap: a versatile alternative for various soft tissue defects

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Microsurgery

Background:

• Perforator flaps represent an advancement in reconstructive surgery.
• The thoracodorsal artery perforator (TDAP) flap is a newer option within this category.
• Understanding the anatomical variations and clinical applications of TDAP flaps is crucial.

Purpose of the Study:

• To describe the utilization of pedicled and free TDAP flaps for reconstructing various soft tissue defects.
• To document the outcomes and complication rates associated with TDAP flap usage.

Main Methods:

• Retrospective analysis of 15 patients undergoing soft tissue reconstruction with 16 TDAP flaps.
• Classification of flaps into pedicled (n=12) and free (n=4) types.
• Preoperative identification of thoracodorsal artery perforators and documentation of flap harvest sites.

Main Results:

• Pedicled TDAP flaps were used for axillary, breast, and shoulder reconstructions.
• Free TDAP flaps were employed for cheek, popliteal fossa, hand, and foot defects.
• A single major complication (flap loss) occurred in 16 flaps, with minor complications in 12.5%.

Conclusions:

• The TDAP flap is a versatile option for soft tissue reconstruction, applicable in both pedicled and free configurations.
• Accurate preoperative localization of perforators aids in flap harvest, despite anatomical variability.
• TDAP flaps demonstrate a favorable safety profile with low major complication rates.