Estimation of Profunda Artery Perforator Flap Weight Using Preoperative Computed Tomography Angiography

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Medical Imaging

Background:

• Thigh-based flaps, including profunda artery perforator (PAP) flaps, are used in breast reconstruction.
• Accurate preoperative estimation of flap weight is essential for successful multiflap reconstructions due to the limited size of these flaps.

Purpose of the Study:

• To develop a novel and accurate technique for estimating the weight of transverse PAP flaps before surgery.
• To aid in preoperative planning for breast reconstruction using PAP flaps.

Main Methods:

• Retrospective review of patients undergoing transverse PAP flap breast reconstruction at two institutions.
• Measurement of subcutaneous tissue thickness on computed tomography angiography (CTA) scans.
• Recording the distance from the gluteal crease to the PAP.
• Utilizing linear regression to develop a predictive formula for flap weight.

Main Results:

• Analysis of 32 flaps from 18 patients.
• A predictive model (R² = 0.80) was developed using subcutaneous tissue thickness, PAP distance, and patient scan position.
• The formula accurately estimated flap weight with a median error of 10.5%.

Conclusions:

• A simple and accurate formula for preoperative estimation of transverse PAP flap weight has been demonstrated.
• This technique can enhance the precision of preoperative planning in breast reconstruction.