Consecutive 265 Profunda Artery Perforator Flaps: Refinements, Satisfaction, and Functional Outcomes

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Microsurgery

Background:

• The deep inferior epigastric (DIEP) flap is a common choice for autologous breast reconstruction.
• When DIEP flaps are unsuitable, alternative autologous options are necessary.
• The profunda artery perforator (PAP) flap from the thigh is a secondary choice for breast mound restoration.

Purpose of the Study:

• To evaluate the safety and efficacy of the profunda artery perforator (PAP) flap for breast reconstruction.
• To assess patient satisfaction and functional outcomes following PAP flap breast reconstruction.
• To compare PAP flap outcomes with established breast reconstruction techniques.

Main Methods:

• Retrospective review of 265 consecutive PAP flaps for breast reconstruction.
• Analysis of patient demographics, perioperative data, and postoperative complications.
• Utilized Breast Q and Lower Extremity Functional Scale (LEFS) for outcome assessment.

Main Results:

• 265 PAP flaps were used in 138 patients for unilateral and bilateral breast reconstruction.
• Complication rates included 3% total flap loss, 4.9% donor site cellulitis, and 6.8% significant donor site wounds.
• Patient satisfaction with breast reconstruction was 78.9%, and with the thigh donor site was 82.1%.

Conclusions:

• The PAP flap is an effective autologous option for breast reconstruction.
• PAP flap success rates and complication profiles are comparable to other reconstructive methods.
• No significant long-term loss of lower extremity function was observed, with high patient satisfaction.