Reconstruction of diabetic lower leg and foot soft tissue defects using thoracodorsal artery perforator chimeric flaps

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.

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Pedicled Thoracodorsal Artery Perforator Flap to Resurface Locoregional Soft Tissue Defects-A Prospective Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2019/37186.12651 ◽

2019 ◽

Author(s):

Prabir Kumar Jash ◽

Mainak Mallik ◽

Santanu Suba

Keyword(s):

Soft Tissue ◽

Prospective Study ◽

Perforator Flap ◽

Soft Tissue Defects ◽

Thoracodorsal Artery ◽

A Prospective Study ◽

Thoracodorsal Artery Perforator Flap ◽

Artery Perforator ◽

Tissue Defects

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Reconstruction of soft tissue defects of the lower leg with the distally based medial adipofascial flap

British Journal of Plastic Surgery ◽

10.1016/0007-1226(94)90173-2 ◽

1994 ◽

Vol 47 (2) ◽

pp. 132-137 ◽

Cited By ~ 29

Author(s):

Sin-Daw Lin ◽

Chung-Sheng Lai ◽

Chih-Kang Chou ◽

Chin-Wei Tsai ◽

Chin-Cheng Tsai

Keyword(s):

Soft Tissue ◽

Lower Leg ◽

Soft Tissue Defects ◽

Adipofascial Flap ◽

Distally Based ◽

Tissue Defects

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Peroneal perforator pedicle propeller flap for lower leg soft tissue defect reconstruction: Clinical applications and treatment of venous congestion

Journal of International Medical Research ◽

10.1177/0300060516687229 ◽

2017 ◽

Vol 45 (3) ◽

pp. 1074-1089 ◽

Cited By ~ 10

Author(s):

Lifeng Shen ◽

Yiyang Liu ◽

Chun Zhang ◽

Qiaofeng Guo ◽

Wenhua Huang ◽

...

Keyword(s):

Soft Tissue ◽

Donor Site ◽

Lower Leg ◽

Soft Tissue Defect ◽

Venous Congestion ◽

Peroneal Artery ◽

Soft Tissue Defects ◽

Propeller Flap ◽

Perforator Vessel ◽

Tissue Defects

Objective To describe the characteristics of the perforator vessel in the peroneal artery of the lower leg and to explore the use of perforator pedicle propeller flaps to repair soft tissue defects in the lower leg, heel and foot. Methods This retrospective study enrolled patients with soft tissue defects of the distal lower leg, heel and foot who underwent surgery using peroneal perforator-based propeller flaps. The peroneal artery perforators were identified preoperatively by colour duplex Doppler ultrasound. The flap was designed based on the preoperatively-identified perforator location, with the posterior border of the fibula employed as an axis, and the perforator vessel as the pivot point of rotation. Patients were followed-up to determine the outcomes. Results The study analysed 36 patients (mean age, 39.7 years). The majority of the soft tissue defects were on the heel (20; 55.6%). The donor-site of the flap was closed in 11 patients by direct suturing and skin grafting was undertaken in 25 patients. Postoperative complications included venous congestion (nine patients), which was managed with delayed wound coverage and bleeding therapy. All wounds were eventually cured and the flaps were cosmetically acceptable. Conclusions The peroneal perforator pedicle propeller flap is an appropriate choice to repair soft tissue defects of the distal limbs.

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