Donor-Site Morbidity and Quality of Life after Autologous Breast Reconstruction with PAP versus TMG Flap

Abstract

The transverse myocutaneous gracilis (TMG) and the profunda artery perforator (PAP) flap are both safe choices for autologous breast reconstruction originating from the same donor region in the upper thigh. We aimed to compare the post-operative outcome regarding donor-site morbidity and quality of life. We included 18 patients who had undergone autologous breast reconstruction with a PAP flap (n = 27 flaps). Prospective evaluation of donor-site morbidity was performed by applying the same questionnaire that had already been established in a previous study evaluating TMG flap (n = 25 flaps) outcome, and results were compared. Comparison of the two patient groups showed equivalent results concerning patient-reported visibility of the donor-site scar and thigh symmetry. Still, the TMG group was significantly more satisfied with the scar (p = 0.015) and its position (p = 0.001). No difference was found regarding the ability to sit for prolonged periods. Donor-site wound complications were seen more frequently in the PAP group (29.6%) than in the TMG group (4.0%). Both groups expressed rather high satisfaction with their quality of life. Both flaps show minimal functional donor-site morbidity and high patient satisfaction. To minimize wound healing problems in PAP patients, thorough planning of the skin paddle is necessary.

Long-Term Results after Autologous Breast Reconstruction with DIEP versus PAP Flaps Based on Quality of Life and Aesthetic Outcome Analysis

“…Besides flap characteristics, donor site morbidity must be well considered for an evaluation of the surgical methods. Preliminary studies demonstrate that functional deficits are rare in thigh donor sites, but they may cause concern regarding the ability to sit for prolonged periods or the restriction of leisure activities, such as bike-riding, stretching, hiking, and climbing [25]. Haddock reports a return to normal lower extremity musculoskeletal condition after six months and high patient satisfaction after PAP harvesting [23].…”

Long-term Results after Autologous Breast Reconstruction with DIEP Versus PAP Flaps based on Quality of Life and Aesthetic Outcome Analysis

“…Besides flap characteristics, donor-site morbidity must be well considered for evaluation of surgical methods. Preliminary studies demonstrate that functional deficits are rare in thigh donorsites, but they may concern the ability to sit for prolonged periods or restriction in leisure activities such as bike-riding, stretching, hiking and climbing [26]. Haddock reports a return to normal lower extremity musculoskeletal condition by six months and high patient satisfaction after PAP harvesting [24].…”