THORACODORSAL ARTERY PERFORATOR FLAP FOR UPPER LIMB RECONSTRUCTION

Area of Science:

• Plastic and Reconstructive Surgery
• Microsurgery
• Orthopedic Surgery

Background:

• Thoracodorsal artery perforator (TAP) flaps are a viable option for reconstructing upper limb defects requiring only skin and subcutaneous tissue.
• TAP flaps offer a good solution for defects where muscle preservation is not essential.

Observation:

• Five patients with upper limb defects (burns, trauma, cancer excision, hidradenitis suppurativa) underwent reconstruction.
• Three pedicled and two free TAP flaps were used, primarily raised on single perforators.
• Preoperative Doppler ultrasound identified perforators; recipient sites included axilla, shoulder, and hand.

Findings:

• All five TAP flaps survived with no major complications, showing good initial vascularity.
• Flaps were raised on eccentrically placed perforators originating from the descending branch of the thoracodorsal artery.
• Donor sites were primarily closed in four cases, with one requiring split-thickness skin grafting.

Implications:

• TAP flaps are suitable for large, shallow upper limb defects due to favorable skin characteristics and a concealed donor site.
• The reliable perforator pedicle and muscle sparing make TAP flaps advantageous.
• This technique offers a promising solution for complex upper limb soft tissue reconstruction.