The profunda artery perforator flap for head and neck reconstruction

Liu, Sara; Hanick, Andrea; Meleca, Joseph B.; Roskies, Michael; Hadford, Stephen; Genther, Dane J.; Ciolek, Peter J.; Lamarre, Eric; Ku, Jamie

doi:10.1016/j.amjoto.2022.103772

Cited by 3 publications

(1 citation statement)

References 26 publications

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“…The perforator anatomy again has proven to be remarkably reliable and likely more reliable than the ALT, which can have tremendous variation and in some circumstances may not have any suitable perforators at all. For many head and neck patients who suffer from weight loss due to the extensive tumor burden, pain, trismus, or the sequelae of previous radiation, the PAP can provide tissue that is thicker than the ALT ( Figure 5 and Figure 6 ) [ 24 , 25 , 26 ]. The length of the flap can be tailored to the size of the defect, but the width that can be harvested is variable from patient to patient and is dependent on the laxity in the donor site.…”

Section: Profunda Artery Perforator Flapmentioning

confidence: 99%

Expanding the Armamentarium of Donor Sites in Microvascular Head and Neck Reconstruction

Lee,

Canzi,

et al. 2024

JCM

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The field of microsurgical head and neck reconstruction has witnessed tremendous advancements in recent years. While the historic goals of reconstruction were simply to maximize flap survival, optimizing both aesthetic and functional outcomes has now become the priority. With an increased understanding of perforator anatomy, improved technology in instruments and microscopes, and high flap success rates, the reconstructive microsurgeon can push the envelope in harvesting and designing the ideal flap to aid patients following tumor extirpation. Furthermore, with improvements in cancer treatment leading to improved patient survival and prognosis, it becomes increasingly important to have a broader repertoire of donor sites. The present review aims to provide a review of newly emerging soft tissue flap options in head and neck reconstruction. While certainly a number of bony flap options also exist, the present review will focus on soft tissue flaps that can be harvested reliably from a variety of alternate donor sites. From the upper extremity, the ulnar forearm as well as the lateral arm, and from the lower extremity, the profunda artery perforator, medial sural artery perforator, and superficial circumflex iliac perforator flaps will be discussed, and we will provide details to aid reconstructive microsurgeons in incorporating these alternative flaps into their armamentarium.

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Section: Profunda Artery Perforator Flapmentioning

confidence: 99%

Expanding the Armamentarium of Donor Sites in Microvascular Head and Neck Reconstruction

Lee,

Canzi,

et al. 2024

JCM

View full text Add to dashboard Cite

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Surgical outcomes of profunda artery perforator flap in head and neck reconstruction: A systematic review and meta‐analysis

Marchi,

Iandelli,

Pace

et al. 2024

Head & Neck

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ObjectiveThis study aims to evaluate the efficacy of the profunda artery perforator (PAP) flap in head and neck reconstruction.MethodsA single arm meta‐analysis was performed for flap survival rate (primary outcome), reoperation for major complication, and overall complication rates (secondary outcomes).ResultsThe search strategy yielded a total of 295 potentially relevant publications, of which 13 were included. A total of 305 patients (males: 80.8%, n = 232/281), with a median age of 56.1 years (n = 305/305; 95% CI 53.9–63), who underwent a total of 307 PAP flap reconstructions for head and neck defects were included. Flap survival rate was 100% (n = 306/307; 95% CI 99.6%–100%), with a reoperation rate for major complications of 3.7% (n = 15/307; 95% CI 1.85%–6.1%) and an overall complication rate of 26.5% (n = 92/307; 95% CI 15.7%–38.9%). Notable postoperative complications included wound dehiscence (n = 15/307, 4.9%), delayed healing (n = 14/307, 4.6%), and wound infection (n = 12/307, 3.9%). Partial flap necrosis and hematoma occurred in 2.6% of cases (n = 8/307), while arterial and venous thrombosis were documented in 0.7% (n = 2/307) and 1.3%, respectively (n = 4/307).ConclusionThe application of the PAP flap in head and neck reconstructions showed several favorable aspects, such as an exceptionally low flap failure rate, versatility in achieving variable dimensions, and a relatively low incidence of complications. PAP flap might be considered as a compelling alternative to the traditionally employed soft tissue free flaps in head and neck reconstruction.

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