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Shoulder function after harvesting a thoracodorsal artery perforator flap
Moustapha Hamdi1, Tina Decorte, Martine Demuynck
1Ghent, Belgium From the Plastic Surgery Department, the Physical Medicine and Rehabilitation Department, the Medical Informatics and Statistics Department, and the Gynecology Department, Ghent University Hospital.
Harvesting a thoracodorsal artery perforator flap for breast reconstruction minimally impacts donor sites. Sparing the latissimus dorsi muscle preserves strength, though some shoulder mobility is reduced, offering a viable alternative for reconstruction.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Microsurgery
Background:
- The thoracodorsal artery perforator flap is an alternative to the latissimus dorsi musculocutaneous flap for breast reconstruction.
- Evaluating donor-site morbidity and shoulder function after harvesting a thoracodorsal artery perforator flap is crucial.
Purpose of the Study:
- To assess the donor site following thoracodorsal artery perforator flap harvest for breast reconstruction.
- To demonstrate the benefits of preserving the latissimus dorsi muscle for shoulder function.
Main Methods:
- A functional study involving 22 patients undergoing partial breast reconstruction with a pedicled thoracodorsal artery perforator flap.
- Postoperative evaluation of latissimus dorsi muscle strength, shoulder mobility, and latissimus dorsi thickness using MicroFet2, goniometer, and ultrasound.
- Statistical analysis comparing operated and contralateral sides.
Main Results:
- Latissimus dorsi strength was maintained post-surgery.
- Shoulder mobility showed no significant difference overall, but active/passive forward elevation and passive abduction were significantly reduced.
- Latissimus dorsi thickness remained unaffected, and no seroma occurred at donor sites.
Conclusions:
- Donor-site morbidity is minimal after thoracodorsal artery perforator flap harvest.
- Perforator flaps are recommended for reconstruction when suitable perforators are available and safely dissectable.
