Anatomical Study and Clinical Application of Free Thoracoacromial Artery True-Perforator Flap for Reconstruction of the Face

Abstract Background: Large or complex trachea defects often require some tissue to reconstruct,various flaps have been reported for reconstructing this defect.However, pedicled thoracoacromial artery perforator flap have not been reported in tracheal reconstruction.Therefore,this study is to assess the efficacy and clinical application of pedicled thoracoacromial artery perforator flaps for tracheal reconstruction.Methods: Eight patients who underwent tracheal reconstructions with pedicled TAAP flaps between December 2017 and October 2019 were retrospectively reviewed.Results: All of the pedicled TAAP flaps in our study survived. The flap size ranged from 2 cm x 5 cm to 4 cm x 10 cm, and the size of each island of one double-island flap was 2 cm x 2.5 cm. The mean thickness was 0.6 cm, and the pedicle length varied between 6 cm and 9 cm (mean 7.9 cm). The mean time of flap harvest was 17 min. The mean age of the patients was 62.4 years and five elderly patients had comorbidities,such as diabetes,hypertension and asthma. One patient received a double-island flap for tracheal and esophageal reconstruction, and the other patient received simple tracheal reconstruction. One patient died due to cancer metastasis.Six patients obtained functional recovery of breathing, except one patients who did not experience closure of the tracheostomy opening due to uncompleted I131 treatment.Conclusion: Pedicled TAAP flaps provide a short harvesting time, thin thickness and stable blood supply, and they do not require microsurgical skills. This flap is a good choice for the reconstruction of tracheal defects,especially in the aged or patients with comorbidities who are not able to tolerate prolonged surgery.

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Response to “The ulnar palmar perforator flap: Anatomical study and clinical application”

Journal of Plastic Reconstructive & Aesthetic Surgery ◽

10.1016/j.bjps.2014.05.035 ◽

2014 ◽

Vol 67 (10) ◽

pp. 1452-1453

Author(s):

Francesca Toia ◽

Pierluigi Tos ◽

Adriana Cordova

Keyword(s):

Clinical Application ◽

Perforator Flap ◽

Anatomical Study

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Foot reconstruction using a free proximal peroneal artery perforator flap: Anatomical study and clinical application

Journal of Plastic Reconstructive & Aesthetic Surgery ◽

10.1016/j.bjps.2018.01.044 ◽

2018 ◽

Vol 71 (6) ◽

pp. 883-888 ◽

Cited By ~ 1

Author(s):

Hyun Ho Han ◽

Yeon Ji Lee ◽

Suk-Ho Moon

Keyword(s):

Clinical Application ◽

Perforator Flap ◽

Anatomical Study ◽

Peroneal Artery ◽

Foot Reconstruction ◽

Artery Perforator

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Perforator flaps based on the deltoid branch of the thoracoacromial artery: anatomical study

Anatomy (International Journal of Experimental and Clinical Anatomy) ◽

10.2399/ana.21.040121 ◽

2021 ◽

Vol 15 (1) ◽

pp. 36-43

Author(s):

Philippe Manyacka Ma Nyemb ◽

Christian Fontaine3 ◽

Véronique Duquennoy-Martinot ◽

Xavier Demondion

Keyword(s):

Perforator Flap ◽

Anatomical Study ◽

Free Flaps ◽

Average Diameter ◽

Cervical Region ◽

Anatomical Landmarks ◽

Perforator Flaps ◽

Thoracoacromial Artery ◽

Lateral Triangle ◽

Perforator Arteries

Objectives: Tissue defects in the lateral triangle of the neck and the anterior cervical region represent a high demand for plastic and reconstructive surgery. Their management most often requires regional or free flaps. The perforator flap based on the deltoid branch of the thoracoacromial artery (TAA) may be a good solution for these indications. The objective of this work is to propose anatomical landmarks to raise perforator flaps pedicled on the deltoid branch of the TAA. Methods: We carried out dissection of 24 perforator flaps based on the deltoid branch of the TAA, in body donor specimens preserved in a glycerin-rich, formalin-free solution. The TAA was first injected with methylene blue. The vascular territory, location of perforators relative to known landmarks, along with the flap’s potential amplitude and arc of rotation were studied. Results: The main perforating arteries of the flap were located in the middle of the deltopectoral groove, often surrounded by adipose tissue in 18 out of 24 dissections. In 22 out of 24 dissections, there were at least 2 perforator arteries originating from the deltoid branch. The average diameter of the perforator arteries was 1 mm. The flap’s amplitude of movement made it possible to reach in all cases the lateral triangle of the neck and the anterolateral cervical region. Conclusion: The thoracoacromial artery has already been used for perforator flaps. However, the individualization of its deltoid branch offers to practitioners new surgical options. This anatomical study of the perforator flap based on the deltoid branch of the TAA made it possible to review the anatomical bases for the raising of this flap, and to fix useful landmarks for the surgeon in order to propose an easily feasible surgical technique.

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Anatomical study and clinical application of medial sural artery perforator flap for oral cavity reconstruction

Annals of Anatomy - Anatomischer Anzeiger ◽

10.1016/j.aanat.2019.151418 ◽

2020 ◽

Vol 227 ◽

pp. 151418

Author(s):

Qiu-wangyue Sun ◽

Peng-fei Gao ◽

Chen-xing Wang ◽

Xiao-meng Song ◽

Xu Ding ◽

...

Keyword(s):

Oral Cavity ◽

Clinical Application ◽

Perforator Flap ◽

Anatomical Study ◽

Oral Cavity Reconstruction ◽

Sural Artery ◽

Artery Perforator

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Clinical application of pedicled thoracoacromial artery perforator flaps for tracheal reconstruction

BMC Surgery ◽

10.1186/s12893-020-00972-9 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Di Deng ◽

Feng Xu ◽

Jifeng Liu ◽

Bo Li ◽

Linke Li ◽

...

Keyword(s):

Clinical Application ◽

Cancer Metastasis ◽

Perforator Flap ◽

Island Flap ◽

Esophageal Reconstruction ◽

Perforator Flaps ◽

Tracheal Reconstruction ◽

Thoracoacromial Artery ◽

The Mean ◽

Artery Perforator

Abstract Background Large or complex trachea defects often require some tissue to reconstruct, various flaps have been reported for reconstructing this defect. However, pedicled thoracoacromial artery perforator flap have not been reported in tracheal reconstruction. Therefore, this study is to assess the efficacy and clinical application of pedicled thoracoacromial artery perforator flaps for tracheal reconstruction. Methods Eight patients who underwent tracheal reconstructions with pedicled TAAP flaps between December 2017 and October 2019 were retrospectively reviewed. Results All of the pedicled TAAP flaps in our study survived. The flap size ranged from 2 cm × 5 cm to 4 cm × 10 cm, and the size of each island of one double-island flap was 2 cm × 2.5 cm. The mean thickness was 0.6 cm, and the pedicle length varied between 6 and 9 cm (mean 7.9 cm). The mean time of flap harvest was 17 min. The mean age of the patients was 62.4 years and five elderly patients had comorbidities, such as diabetes, hypertension and asthma. One patient received a double-island flap for tracheal and esophageal reconstruction, and the other patient received simple tracheal reconstruction. One patient died due to cancer metastasis. Six patients obtained functional recovery of breathing, except one patients who did not experience closure of the tracheostomy opening due to uncompleted I131 treatment. Conclusion Pedicled TAAP flaps provide a short harvesting time, thin thickness and stable blood supply, and they do not require microsurgical skills. This flap is a good choice for the reconstruction of tracheal defects, especially in the aged or patients with comorbidities who are not able to tolerate prolonged surgery.

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