[Breast reconstruction with profunda artery perforator flap: A prospective study of 30 consecutive cases]

Many flaps have been described in autologous breast reconstruction, the most common being the deep inferior epigastric perforator (DIEP) flap. This flap cannot be harvested in a certain range of patients. The profunda artery perforator (PAP) flap, based on perforators from profunda femoral artery, is therefore a good option.

The goal was to highlight technical tips, particularities, and complications of our series of the 30 first PAP flaps for breast reconstruction in our department.

We did a prospective study of all PAP flaps for breast reconstruction between November 2014 and October 2015. Thirty patients were included. We used 2 different types of skin design: classical or with vertical extension. The following parameters were recorded: pedicle length, flap weight, surgery duration, complications on donor or recipient site and type of recipient vessels.

Seventy-seven percent of the cases were delayed breast reconstruction, 23% were immediate. Twenty-five flaps were with classical skin design, and 5 with vertical extension. Mean flap weight was 301g (195-700g). Mean pedicle length was 9.88cm (8.2-12.5cm). Internal mammary vessels were the recipient vessels for 90% of the patients, versus 10% for circumflex scapular vessels. Mean surgery duration was 328min (195-610min). We had two total flap failures. The complications on the donor-site were 2 seroma, and 4 late healing scars. No lymphoedema occurred.

PAP flap is a good option when abdominal flap harvesting is not possible. The donor-site is well tolerated, with low morbidity. The indication is for patients with small to medium breast volume.