Thoracodorsal artery perforator fasciocutaneous flap: A versatile alternative for coverage of various soft tissue defects

Abstract

Objective:The thoracodorsal artery perforator (TDAP) flap has contributed to the efficient reconstruction of tissue defects that require a large amount of cutaneous tissue. The optimal reconstruction method should provide thin, and well-vascularized tissue with minimal donor-site morbidity. The indications for the use of this particular flap with other flaps are discussed in this article.Materials and Methods:Thirteen patients underwent soft tissue reconstruction using TDAP flaps between 2009 and 2011. Of those, there were four cases of antecubital burn contracture, three cases of axillary burn contracture, two cases of giant hair cell nevus of upper extremity, two cases of axillary reconstruction following severe recurrent hidradenitis, and two cases of crush injury. All patients were male and their ages ranged from 20 to 23 (average, 21 years). The mean follow-up period was 8 months (range, 4-22 months).Results:All reconstructive procedures were completed without any major complications. Minor complications related to transfered flaps were wound dehiscence in one case, transient venous congestion in two cases. Minor complication related to the donor site was seroma in one case. The success rate was 100%, with satisfactory cosmetic results.Conclusions:The TDAP flap is a safe and extremely versatile flap that offers significant advantages in acute and delayed reconstruction. Although the vascular anatomy may be variable, free and pedicled TDAP flap is a versatile alternative for soft tissue defects. It adapts very well to the soft tissue defects with acceptable donor site scar.

Clinical Applications of the Thoracodorsal Artery Perforator Flap in Extremity Soft Tissue Reconstruction

“…The donor site was closed primarily in 16 cases (80%). Although there are some studies denoting the ability to primarily close the donor site of the TDAP flap up to 12cm width [14], we found that the maximum width that can be closed primarily is 10cm and this is attributed to the presence of all intact LD muscle in the field.…”

Shoulder-related donor site morbidity and patient-reported satisfaction after delayed breast reconstruction with pedicled flaps from the back: A comparative analysis

“…The pedicled thoracodorsal artery perforator flap (TAP flap) has been demonstrated to be a versatile flap, suitable for several reconstructive purposes. [1][2][3][4][5] Its use and benefits in breast reconstruction has been established previously. [6][7][8][9][10][11][12][13][14][15][16][17] Several publications describe the TAP-flap combined with an implant for total breast reconstruction, suggesting it as an alternative to the conventional musculocutaneous latissimus dorsi flap (LD flap).…”

Knee and Ankle Reconstruction With Reverse Anterolateral Thigh and Free Anterolateral Thigh Flap From One Donor Site

“…The TDAP free flap can provide a large skin paddle and long pedicle, similar to the ALT free flap. 12 However, in the present case, a position change during operation would be needed using the TDAP free flap. The TDAP free flap was planned as an option for covering when the reverse ALT flap was not possible.…”