Septocutaneous thoracodorsal artery perforator flaps: a retrospective cohort study

Miyamoto, Shimpei; Arikawa, Masaki; Kagaya, Yu; Fukunaga, Yutaka

doi:10.1016/j.bjps.2018.08.026

Cited by 17 publications

(15 citation statements)

References 17 publications

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“…Septocutaneous perforators are located anteriorly to the LD muscle having a circummuscular course. 40 – 42 These were present in about 60% of cases 40 , 42 and allow for the avoidance of intramuscular dissection and thus shorten operative time. In our review, Hamdi et al reported septocutaneous TDAP flaps in 2 cases.…”

Section: Discussionmentioning

confidence: 99%

Thoracodorsal Artery Perforator Flap in Partial Breast Reconstruction: A Systematic Review

Mangialardi

Baldelli

Salgarello

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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Introduction: Breast conserving surgery followed by radiation therapy represents the standard of care for early stage breast cancer. Oncoplastic breast surgery includes several reconstructive techniques essentially summarized in 2 categories: volume displacement and volume replacement procedures. These latest procedures have evolved over time from the use of the entire latissimus dorsi muscle to the use of pedicled perforator flaps, namely the thoracodorsal artery perforator (TDAP) flap. The aim of this article is to provide a comprehensive review of the literature regarding the use of the TDAP flap in partial breast defects. Methods: A literature search was performed via PubMed, Medline, and Cochrane. Studies reporting the use of the TDAP flap after breast conserving surgery were included. Patient characteristics, topography and size of breast defect, flap size and design, number of perforators, and operative time were analyzed. Moreover, aesthetic and functional (shoulder morbidity) results, patient satisfaction, postoperative complications, and donor site morbidity were registered. Results: Twelve articles fulfilled inclusion criteria, and 337 patients were included. All articles except 1 described the use of the TDAP flap for defects in every breast quadrant. The mean weight of resected breast tissue was 97.28 g, and patients with over 20% of volume deficiency were considered eligible for TDAP flap volume replacement. The ellipse-shaped skin paddle (oriented oblique downward, transversal or oblique upward in most cases) was extended over the anterior border of the latissimus dorsi muscle to include possible septocutaneous perforator vessels. Most authors began the dissection from the anterior and caudal border of the flap to reserve the possibility to convert the TDAP to a musculocutaneous flap and check for septocutaneous perforators. Flap size ranged from 4 × 12 to 21 × 9 cm. The mean procedure time was 192.21 minutes. Mean follow-up was 17.42 months. Evaluation by way of a 5-point Likert scale reported overall mean values of over 4 points. Satisfactory outcomes were reported in 92.85%–100% of cases. Patient satisfaction ranged from 80% to 94% of cases. The incidence of seroma (1 case) and “shoulder-related” donor site morbidity was very low. Conclusions: Despite the heterogeneity of the evaluation methods, our review suggested that the use of the TDAP flap in oncoplastic surgery allows for satisfactory aesthetic outcomes and quite high levels of patient satisfaction. The TDAP flap represents an effective and versatile tool that amplifies the oncoplastic surgeon’s arsenal, which allows for satisfactory outcomes.

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Section: Discussionmentioning

confidence: 99%

Thoracodorsal Artery Perforator Flap in Partial Breast Reconstruction: A Systematic Review

Mangialardi

Baldelli

Salgarello

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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“…The popular flaps for soft‐tissue reconstruction other than the lower abdominal perforator flaps are the anterolateral thigh flap and the thoracodorsal artery perforator flap (Miyamoto, Arikawa, Kagaya, & Fukunaga, ; Miyamoto, Fujiki, Kawai, Chuman, & Sakuraba, ; Miyamoto, Fujiki, & Sakuraba, ). The lower abdominal perforator flaps are usually thicker than the other two flaps and are not suitable for reconstruction of the distal extremities.…”

Section: Discussionmentioning

confidence: 99%

The use of lower abdominal perforator flaps in soft‐tissue reconstruction after sarcoma resection

2019

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Background Historically, conventional musculocutaneous flaps have been commonly used for reconstruction after soft tissue sarcoma resection, and the use of lower abdominal perforator flaps has not been popular. This report examined the current role of lower abdominal perforator flaps in sarcoma treatment. Methods We reviewed the outcomes of 14 patients (mean age: 46.3 years, range: 18–79 years) who underwent immediate reconstruction with a deep inferior epigastric artery perforator (DIEP) flap or a superficial inferior epigastric artery (SIEA) flap after sarcoma resection. The defects ranged in size from 7 × 6 cm2 to 25 × 22 cm2 (mean: 16.5 × 12.1 cm2). An oblique design was used for pedicled DIEP flaps and a transverse design for free DIEP flaps. Results Free SIEA flaps were used in six patients, pedicled DIEP flaps in five, and free DIEP flaps in three. The flaps ranged in size from 13 × 8 cm2 to 36 × 12.5 cm2 (mean: 23.1 × 9.2 cm2). All DIEP flaps except one were harvested based on one dominant perforator. All flaps survived without vascular compromise. Surgical site infection and seroma occurred at the recipient site in one patient each. No donor‐site complications occurred. Conclusions Lower abdominal perforator flaps can serve as a versatile donor site for reconstruction after sarcoma resection.

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“…With increased experience of flap elevation operative time decreased but other technique may offer more decrease in operative time according to Miyamoto et al (17) who state the use of the septocutaneous thoracodorsal artery perforator (TDAP-sc) flap that depend on septocutaneous perforator from the thoracodorsal vessels that has its way around the free lateral border of the LD muscle without penetrating the muscle. Therefore, the tedious intramuscular dissection unnecessary and facilitate TDAP flap harvest.…”

Section: Discussionmentioning

confidence: 99%

Versatility of the Pedicled Thoracodorsal Artery Perforator Flap (TDAP) Anatomic Basis and Clinical Application in breast reconstruction

Attia

Mansy²,

elwahsh

et al. 2019

Zagazig University Medical Journal

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Septocutaneous thoracodorsal artery perforator flaps: a retrospective cohort study

Cited by 17 publications

References 17 publications

Thoracodorsal Artery Perforator Flap in Partial Breast Reconstruction: A Systematic Review

Thoracodorsal Artery Perforator Flap in Partial Breast Reconstruction: A Systematic Review

The use of lower abdominal perforator flaps in soft‐tissue reconstruction after sarcoma resection

Versatility of the Pedicled Thoracodorsal Artery Perforator Flap (TDAP) Anatomic Basis and Clinical Application in breast reconstruction

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