Reconstruction mammaire par profunda artery perforator flap : étude prospective des 30 premiers cas consécutifs

Haddad, Kevin; Hunsinger, Vincent; Obadia, Déborah; Hivelin, Mikaël; Lantieri, Laurent

doi:10.1016/j.anplas.2016.02.004

Cited by 14 publications

(7 citation statements)

References 29 publications

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“…Indeed, the PAP flap offers all the benefits of the perforator flap surgery, such as the transfer of a large amount of soft tissue and decreased morbidity, especially at the donor site. 1,6,11 Moreover, the PAP flap presents several advantages over its competitors, such as SGAP, IGAP, or TUG flaps, including its reportedly easier harvest. 3,8,12,13 Perforator caliber and pedicle length are also reliable characteristics supporting the PAP flap.…”

Section: Discussionmentioning

confidence: 99%

“…3,8,12,13 Perforator caliber and pedicle length are also reliable characteristics supporting the PAP flap. 2,4,6,14 Finally, the donor site scar is less visible than the DIEP, SGAP, and even the TUG flap, which are more anterior scars, and the PAP flap does not modify the gluteal fold, as does the IGAP flap. 4,6 In the study from Allen et al, 4 the average PAP flap weight was 385 g. In the study by Satake et al, 7 the average PAP flap weight was 199.8 g for immediate breast reconstructions and 244.6 g for delayed reconstructions.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4] The profunda femoris artery perforator (PAP) flap is our second choice in the current trend for autologous microsurgical breast reconstruction, when a DIEP flap procedure is unsuitable. 5,6 In its early description, the PAP flap was designed as a horizontal ellipse parallel to the inferior gluteal fold. 4,7 In this setting, the PAP flap is recognized to provide a valuable option for the reconstruction of small-and medium-sized breasts.…”

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confidence: 99%

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Medium- and Large-Sized Autologous Breast Reconstruction using a Fleur-de-lys Profunda Femoris Artery Perforator Flap Design: A Report Comparing Results with the Horizontal Profunda Femoris Artery Perforator Flap

Hunsinger

Lhuaire

Haddad

et al. 2018

J reconstr Microsurg

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Medium- and Large-Sized Autologous Breast Reconstruction using a Fleur-de-lys Profunda Femoris Artery Perforator Flap Design: A Report Comparing Results with the Horizontal Profunda Femoris Artery Perforator Flap

Hunsinger

Lhuaire

Haddad

et al. 2018

J reconstr Microsurg

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“…2). Three articles [31][32][33] were written in French and were translated. Nine articles (33.3%) were published in the United States, and the remaining 18 (66.67%) were conducted in Europe and the United Kingdom (Fig.…”

Section: Article Demographicsmentioning

confidence: 99%

A Systematic Review and Meta-Analysis Comparing the Clinical Outcomes of Profunda Artery Perforator Versus Gracilis Thigh Flap as a Second Choice for Autologous Breast Reconstruction

et al. 2023

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Purpose Autologous breast reconstruction remains a versatile option to produce a natural appearing breast after mastectomy. The deep inferior epigastric perforator remains the most commonly used flap choice, but when this donor site is unsuitable or unavailable, the transverse upper gracilis (TUG) or profunda artery perforator (PAP) flaps are popular secondary alternatives. We conduct a meta-analysis to better understand patient outcomes and adverse events in secondary flap selection in breast reconstruction. Methods A systematic search was conducted on MEDLINE and Embase for all articles published on TUG and/or PAP flaps for oncological breast reconstruction in postmastectomy patients. A proportional meta-analysis was conducted to statistically compare outcomes between PAP and TUG flaps. Results The TUG and PAP flaps were noted to have similar reported rates of success and incidences of hematoma, flap loss, and flap healing (P > 0.05). The TUG flap was noted to have significantly more vascular complications (venous thrombosis, venous congestion, and arterial thrombosis) than the PAP flap (5.0% vs 0.6%, P < 0.01) and significantly greater rates of unplanned reoperations in the acute postoperative period (4.4% vs 1.8%, P = 0.04). Infection, seroma, fat necrosis, donor healing complications, and rates of additional procedures all exhibited high degree of heterogeneity precluding mathematical synthesis of outcomes across studies. Conclusions Compared with TUG flaps, PAP flaps have fewer vascular complications and fewer unplanned reoperations in the acute postoperative period. There is need for greater homogeneity in reported outcomes between studies to enable for synthesis of other variables important in determining flap success.

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“…9 The complication rates at the donor site have been previously published, but the results of these studies have been limited to an examination of tPAP flaps. [9][10][11][12][13][14] The purpose of this study was to analyze the senior author's (R.J.A., Jr) early experience and results with autologous breast reconstruction using PAP flaps, as well as compare demographics, operative details, complication rates, and patient-reported outcome measures (PROMs) between patients reconstructed with tPAP and dPAP flaps. We hypothesized that the dPAP flap design allows for a larger skin paddle and overall volume, without increasing the risk of complications or compromising patient satisfaction.…”

Section: Introductionmentioning

confidence: 99%

The Preferred Design of the Profunda Artery Perforator Flap for Autologous Breast Reconstruction: Transverse or Diagonal?

Cohen,

Azoury,

Nelson

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background: Since its introduction for autologous breast reconstruction in 2010, the profunda artery perforator (PAP) flap has emerged as a preferred choice when an abdominal flap is suboptimal. The traditional transverse design (tPAP) was popularized, given the inconspicuous donor scar. A diagonal design (dPAP) has since evolved to address some of the shortcomings of the tPAP. The authors aimed to compare outcomes of tPAP/dPAP flaps harvested for breast reconstruction by a single surgeon. Methods: A retrospective review was conducted from 2017 to 2022 of patients undergoing tPAP versus dPAP-based breast reconstruction by a single surgeon at a tertiary cancer center. Patient variables and operative variables were assessed. Need for additional symmetrizing breast procedures were compared. Complications and BREAST-Q patient-reported outcome measures were analyzed. Results: Thirty-nine flaps were used to reconstruct 35 breasts in 24 patients. Average follow-up for the group was 1.8 years. The groups were similar with respect to demographics. The majority of dPAP flaps had two perforators, whereas most tPAP flaps had one perforator. The dPAP flaps had greater average weights, width, and overall surface area. There were no cases of partial/total flap loss. Complications and PROM results were similar between the two groups. Conclusions: The dPAP design allows for a larger skin paddle and greater tissue harvest and capture of cutaneous perforators, without increasing the risk of complications or compromising satisfaction. It should be considered as a viable option in patients unable to undergo abdominal-based reconstruction. Additional patients and multi-institutional efforts are necessary to better compare advantages of either design.

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Reconstruction mammaire par profunda artery perforator flap : étude prospective des 30 premiers cas consécutifs

Cited by 14 publications

References 29 publications

Medium- and Large-Sized Autologous Breast Reconstruction using a Fleur-de-lys Profunda Femoris Artery Perforator Flap Design: A Report Comparing Results with the Horizontal Profunda Femoris Artery Perforator Flap

Medium- and Large-Sized Autologous Breast Reconstruction using a Fleur-de-lys Profunda Femoris Artery Perforator Flap Design: A Report Comparing Results with the Horizontal Profunda Femoris Artery Perforator Flap

A Systematic Review and Meta-Analysis Comparing the Clinical Outcomes of Profunda Artery Perforator Versus Gracilis Thigh Flap as a Second Choice for Autologous Breast Reconstruction

The Preferred Design of the Profunda Artery Perforator Flap for Autologous Breast Reconstruction: Transverse or Diagonal?

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