The Lumbar Artery Perforator Flap

Bissell, Mary Beth; Greenspun, David T.; Levine, Josh; Rahal, William; Al-Dhamin, Ammar; Alkhawaji, Ali; Morris, Steven F.

doi:10.1097/sap.0000000000000646

Cited by 29 publications

(28 citation statements)

References 12 publications

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“…Three articles were removed for the various reasons: non–free-tissue transfer, duplicate data published in separate articles, and review article. Eighteen studies were then deemed eligible for inclusion in this systematic review 3,4,6–21 Figure 1. depicts a flow chart of the review process.…”

Section: Resultsmentioning

confidence: 99%

“…As such, caudal perforators are likely to pierce the thoracolumbar fascia further out from midline and traverse musculature septocutaneously. 7,9,19 From our review, 4 studies used in vivo computed tomography angiogram, which may best represent the number of perforators for free tissue transfer in the context of surgical planning. These studies reported 5 ± 2 8 and 3.2 ± 1.68 6 perforators per patient.…”

Section: Discussionmentioning

confidence: 99%

“…9,19 There was no apparent association between lumbar level and pedicle length, and yet the L4 pedicle measured longest in a radiographic study with high resolution. 7 Considering its reliable course and favorable attributes, the L4 perforators may be better suited for flap design. Nevertheless, preoperative computed tomography angiogram or magnetic resonance angiogram would help evaluate these parameters and assist in flap planning.…”

Section: Discussionmentioning

confidence: 99%

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Lumbar Artery Perforator Flaps

et al. 2022

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Background: The lumbar artery perforator (LAP) flap has gained popularity as a versatile flap in reconstructive surgery; however, few studies have analyzed salient characteristics of this flap. We set out to provide a comprehensive appraisal of free tissue transfers of LAP flaps with specific attention to anatomic features and clinical outcomes. Methods: Using preferred reporting items for systematic reviews and meta-analyses guidelines, we identified clinical, radiographic, and cadaveric studies of LAP flaps and assessed outcomes, complications, and anatomic parameters, such as pedicle length, diameter, location, and course. Results: A total of 254 articles were initially reviewed, of which 18 met the final inclusion criteria. Ten studies were primarily concerned with anatomic characteristics, and most clinical studies related to breast reconstruction. The operative durations varied between 4.8 and 9.2 hours. Partial and total flap losses were estimated at 2.6% and 7.6%, respectively. Acute revision rates ranged from 16% to 24% related to hematoma, arterial thrombus, and venous thrombus. Donor-site seromas were frequently encountered in breast reconstruction with an incidence of 17% to 78%. Conclusions:The LAP flap has demonstrated favorable outcomes in various reconstructive scenarios. The caudal perforators generally offer more pedicle length, greater pedicle diameter, and septocutaneous course and may be better suited for flap design. For breast reconstruction, the LAP flap is a useful alternative to abdominalbased flaps, and special attention should be given to optimizing pedicle length using interposition grafts and methods that minimize seroma formation at the donor site.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Lumbar Artery Perforator Flaps

et al. 2022

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“… 1 Initial case series have since detailed the safety of this flap 2 – 5 and helped better characterize the anatomy. 4 , 6 – 9 We present our approach to LAP flaps in an effort to provide a videographic description detailing procedural steps as well as pearls for success.…”

mentioning

confidence: 99%

“…We designed our markings to capture the lumbar perforator, typically arising from L3 or L4, found cranial to the iliac crest and 7–10 cm lateral to midline. 6 – 9 Laterally, the markings are merged with the abdominoplasty scar. Once prone, intraoperative Doppler confirmation is used to confirm general location of the perforator.…”

mentioning

confidence: 99%

Lumbar Artery Perforator Flap: Video Surgical Sequence

Haddock

Dumestre

Teotia

2020

Plastic and Reconstructive Surgery - Global Open

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Modern techniques and alternative flaps in microsurgical breast reconstruction

Seth

Allen

2018

Journal of Surgical Oncology

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Breast reconstruction with autologous tissue has become an essential part of the breast cancer patient care algorithm, with the abdomen being the most common tissue donor site. However, within this field, the technology and surgical techniques available to the reconstructive breast surgeon have evolved over time. This review aims to summarize the literature surrounding current techniques in microsurgical breast reconstruction including the use of alternative, nonabdominal flaps.

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The Lumbar Artery Perforator Flap

Abstract: Perforators arising from the first and fourth LAs arise in a predictable fashion, have adequate pedicle lengths, and are of suitable diameter to support a perforator flap. We present a case to support the potential use of this flap for microvascular breast reconstruction.

Cited by 29 publications

References 12 publications

Lumbar Artery Perforator Flaps

Lumbar Artery Perforator Flaps

Lumbar Artery Perforator Flap: Video Surgical Sequence

Modern techniques and alternative flaps in microsurgical breast reconstruction

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