Muscle electrical activity after perforator flap surgery: a pilot cohort study

Marchesi, Andrea; Amendola, Francesco; Bordone, Francesco; Sterlicchio, Michele; Ponti, V.; Marcelli, Stefano; Tosi, Daniele; Zaccaria, Giovanna; Vaienti, Luca

doi:10.1007/s00238-019-01581-3

Cited by 7 publications

(5 citation statements)

References 9 publications

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“…3,4 As any other perforator flaps, TDAP flap has the great benefits of preserving muscle integrity and decreasing postoperative donor site seromas and shoulder-related sequelae. 5,6 In 2004, Hamdi et al reported the first four cases of partial breast reconstruction with a TDAP flap, while in 2007 Ortiz et al described the first successful experience of implant-based breast reconstruction combined with a TDAP flap.…”

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confidence: 99%

A Retrospective Comparative Analysis of Latissimus Dorsi (LD) Flap Versus Thoracodorsal Artery Perforator (TDAP) Flap in Total Breast Reconstruction with Implants: A Pilot Study

Brambilla

Parisi

Gatto

et al. 2021

J Reconstr Microsurg

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Introduction In breast surgery, an autologous flap combined with implant may reduce the risk or repair the soft-tissue defects in several cases. Traditionally, the preferred flap is the myocutaneous latissimus dorsi (LD) flap. In the perforator flap era, the evolution of LD flap is the thoracodorsal artery perforator (TDAP) flap. The aim of this study is the comparison between LD flap and TDAP flap with implants in terms of early complications and shoulder function. Methods We performed a retrospective cohort study in accordance with the STROBE guidelines. Between January 1 2015 and January 1 2020, 27 women underwent a unilateral total breast reconstruction with LD or TDAP flap combined with an implant at our institution. 15 women were operated with LD flap and 12 with TDAP flap. The most frequent indications for intervention were results of mastectomy and radiation-induced contracture. We evaluated several data in terms of clinical and demographical characteristics, operative and perioperative factors, and follow-up variables. We assessed shoulder function through the Disability of the Arm, Shoulder and Hand Questionnaire (DASH). Results The rate of complications was significantly lower in the TDAP group compared with the LD group (16.7% vs 60.0%, p = 0.047. Table 3). Although the small sample size limited further detailed statistical analyses, we particularly noticed no cases of donor site seroma in the TDAP group, as compared with four in the LD group. Patients in the TDAP group had an ∼11-point lower mean DASH score compared with the LD group (9.8 vs 20.5). This difference was statistically significant (p = 0.049). Conclusions TDAP flap seems to be a reliable technique for soft-tissue coverage in total breast reconstruction with implants. In comparison with the traditional LD flap, it could be a more favorable option in terms of less complications and better quality of life.

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confidence: 99%

A Retrospective Comparative Analysis of Latissimus Dorsi (LD) Flap Versus Thoracodorsal Artery Perforator (TDAP) Flap in Total Breast Reconstruction with Implants: A Pilot Study

Brambilla

Parisi

Gatto

et al. 2021

J Reconstr Microsurg

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“…The choice between a pedicled and a "free" microvascular ap depends on the type of the defect and on the personal surgical expertise [56,57]. In a recently published meta-analysis [54], free-aps and pedicled propeller aps did not show a signi cant difference in terms of overall failure rate (3,9% vs 2,8%, respectively) as well as the "coverage failure" rate (5.2% vs 2.9%, respectively).…”

Section: Resultsmentioning

confidence: 99%

Practical Guidelines for the Orthoplastic Approach: A Systematic Review of High-Quality Evidence for the Lower Extremity Trauma

Amendola,

Cottone,

Alessandri-Bonetti

et al. 2023

Preprint

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Background: The aim of this review is to produce a high-quality evidence-based protocol for lower extremity traumas, from the immediate wound management to the final reconstruction, summarizing only the high-quality evidence present in literature. Methods: Pubmed, EMBASE and Cochrane libraries were searched for high-quality studies on the orthoplastic approach for lower limb traumas. Search terms were: “trauma” OR “fracture”, “lower extremity” OR “lower limb” OR “leg” OR “tibia” OR “fibula”, “bone infection” OR “osteomyelitis”, “orthoplastic”, “flap” OR “reconstruction”. Inclusion criteria were cohort study, clinical trial, randomized controlled trial, systematic review or meta-analysis; lower extremity open fractures; detailed reports about patient and treatment; defined follow-up and outcomes. The PRISMA statement was followed. Exclusion criteria were diabetic foot, open fractures of the foot, not clearly defined protocol of treatment, case series and case reports. Three independent authors (MAB, GC and RC) searched the literature and extracted data from studies, based on eligibility criteria. Results: We summarized the available evidence in three main time settings: fracture management in the emergency department; optimal management during the first 24 hours; optimal management and final goal within 72 hours. Conclusions: The optimal goal is to achieve bone fixation and definitive coverage in a single surgery within 24 hours from injury. If not possible, the main purpose of the orthoplastic team should be the definitive coverage within 72 hours. A dedicated operating room and efficient referral to a specialized trauma center are paramount to reduce infection and costs. Level of evidence: Level II, therapeutic study

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“…It can be argued that the use of pedicled propeller flaps 17 might be a better option compared with PB muscle flap, being less invasive and sparing the muscle. 18 Nevertheless, local fasciocutaneous flaps showed a complication rate of 25.2% in the meta-analysis performed by Bekara et al, 4 with a 3.5% of total flap loss and 10.2% of partial flap loss.…”

Section: Discussionmentioning

confidence: 98%

One-Step Approach for Infections After Achilles Tendon Open Repair: The Distally Based Peroneus Brevis Muscle Flap

Vaienti

Cottone

Zaccaria

et al. 2020

The International Journal of Lower Extremity Wounds

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The aim of this single-center, retrospective study is to demonstrate the effectiveness of distally based peroneus brevis muscle flap as first therapeutic option for infections after Achilles tendon open repair. We retrospectively analyzed 14 consecutive patients with complete Achilles tendon rupture and developing surgical site infection after an attempt of open surgical repair. Every patient was reconstructed with distally base peroneus brevis muscle flap. The primary outcome was the return to work and the initiation of full weight-bearing. Secondary outcomes were complication rate and time needed to return to work. A review of the literature was conducted to better define the actual standard treatment. Each patient returned to work. No flap necrosis occurred. Two minor healing delays and one hematoma were reported. Median time to wound healing was 17 days (interquartile range [IQR] = 13-20). Median time to full weight-bearing was 52 days (IQR = 47-55). Median follow-up (FU) was 21 months. Distally based peroneus brevis flap is a safe treatment for surgical site infections after Achilles tendon rupture repair. Patients regained full weight-bearing after a median time of 52 days from the surgical reconstruction. No major complications were observed. This flap clearly emerges as first reconstructive option for complications after surgery of Achilles tendon region.

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Muscle electrical activity after perforator flap surgery: a pilot cohort study

Cited by 7 publications

References 9 publications

A Retrospective Comparative Analysis of Latissimus Dorsi (LD) Flap Versus Thoracodorsal Artery Perforator (TDAP) Flap in Total Breast Reconstruction with Implants: A Pilot Study

A Retrospective Comparative Analysis of Latissimus Dorsi (LD) Flap Versus Thoracodorsal Artery Perforator (TDAP) Flap in Total Breast Reconstruction with Implants: A Pilot Study

Practical Guidelines for the Orthoplastic Approach: A Systematic Review of High-Quality Evidence for the Lower Extremity Trauma

One-Step Approach for Infections After Achilles Tendon Open Repair: The Distally Based Peroneus Brevis Muscle Flap

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