Abstract:Background:The thoracodorsal artery perforator flap is considered a technically difficult flap because of significant anatomical variations in perforator location. The authors' strategy to facilitate the harvest of these flaps includes careful preoperative mapping of perforators and a standardized planning and harvesting technique. The authors evaluated 99 pedicled thoracodorsal artery perforator flaps, with an emphasis on preoperative planning, surgical technique, and analysis of complications.
“…18 Both are associated with negligible donor site morbidity but with a long scar on the thigh area and the back, respectively. The patient chose the thigh area as a donor site since the scar could be easily covered with a conventional swimming suit.…”
We report a case of a male patient with Poland's anomaly who was reconstructed with a free anterolateral thigh perforator flap. The flap was used successfully as an autologous filler to recreate the anterior axillary line and correct the chest contour deformity. The use of the free anterolateral thigh perforator flap is an excellent choice as an autologous filler to correct mild and moderate deformity in male Poland's syndrome, carrying low morbidity and leaving both minimal scarring and functional sequelae.
“…18 Both are associated with negligible donor site morbidity but with a long scar on the thigh area and the back, respectively. The patient chose the thigh area as a donor site since the scar could be easily covered with a conventional swimming suit.…”
We report a case of a male patient with Poland's anomaly who was reconstructed with a free anterolateral thigh perforator flap. The flap was used successfully as an autologous filler to recreate the anterior axillary line and correct the chest contour deformity. The use of the free anterolateral thigh perforator flap is an excellent choice as an autologous filler to correct mild and moderate deformity in male Poland's syndrome, carrying low morbidity and leaving both minimal scarring and functional sequelae.
“…In a recent study, the shoulder functions were evaluated by measuring the LD muscle strength and thickness after harvesting the pedicled thoracodorsal artery perforator (TDAP) flap in patients who underwent breast surgery, and similar outcomes were obtained between the operated and unoperated sides. 11 Under the name of ''muscle sparing LD flap,'' some pedicled flaps were recently used for partial 12 and total breast reconstruction 8,9 in mastectomy patients, as well as trunk and upper extremity reconstruction, 13 by taking lateral strip of the LD muscle with the flap, which contains the descending branch of the thoracodorsal artery and its perforators. The pivot point of these pedicled flaps was at the bifurcation of the main pedicle into the descending and transverse branches, and the transverse vessel along with the main thoracodorsal nerve was left in situ.…”
In this report, we describe the technique of muscle and nerve sparing latissimus dorsi (LD) flap and evaluate the outcomes of reconstruction of various defects with 12 free and 2 pedicled muscle and nerve sparing LD flaps in 14 patients. The LD muscle functions at operated and nonoperated muscles were evaluated clinically and with electroneuromyography. All flaps survived completely but one which had a partial necrosis. The mean follow-up time was 12.3 months. Adduction and extention ranges of the shoulders were the same bilaterally in all patients. In electroneuromyography, no significant difference was available statistically between the sides. This muscle and nerve sparing latissimus dorsi flap has advantages of thinness, muscle preservation and reliability, and thus can be a good option to other fasciocutaneous flaps in reconstruction surgery.
“…The latissimus flap, usually combined with a definitive implant for breast reconstruction, is the most adequate flap for patients with diabetes or for smokers (61), as it is associated with very few complications (62). Moreover, it is a suitable flap for thin patients, who have a history of abdominal surgeries or intend to carry a future pregnancy (61).…”
Section: Delayed Breast Reconstructionmentioning
confidence: 99%
“…Moreover, it is a suitable flap for thin patients, who have a history of abdominal surgeries or intend to carry a future pregnancy (61). (Figs.…”
RezumatReconstrucţia de sân implică două decizii majore: alegerea momentului optim şi a tehnicii adecvate de reconstrucţie pentru fiecare pacientă, luând în considerare complicaţiile şi riscurile care pot rezulta în urma acestor decizii. Prin selectarea atentă a pacientelor şi individualizarea reconstrucţiei de sân, riscurile şi complicaţiile acestei proceduri pot fi minimizate, cu rezultat estetic bun şi satisfacţie ridicată în rândul pacientelor. Reconstrucţia de sân poate fi realizată prin 3 modalităţi distincte: reconstrucţia imediată -la momentul mastectomiei, reconstrucţia secundară -la finalizarea tratamentului adjuvant şi reconstrucţia imediat-întârziată care utilizează ambele metode precedente -include expansiunea tisulară la momentul mastectomiei şi reconstrucţia definitivă la finalizarea tratamentului adjuvant. Strategiile perfecţionate timp de decenii în chirurgia reconstructivă a sânului au făcut posibilă reconstrucţia imediată a sânului oferind pacientelor şansa de a se recupera după o intervenţie de mastectomie cu un nou sân reconstruit. Deşi nu toate pacientele aleg reconstrucţia sânului, procentele celor care optează pentru reconstrucţie sunt în continuă creştere, iar tehnici noi şi îmbunătăţite se dezvoltă rapid.Cuvinte cheie: cancer de sân, mastectomie, reconstrucţie de sân, conservarea ţesutului cutanat, implant mamar
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