scholarly journals Thoracodorsal artery flaps for breast reconstruction–the variants and its approach

2021 ◽  
Vol 48 (1) ◽  
pp. 15-25
Author(s):  
Jørn Bo Thomsen ◽  
Mikkel Børsen Rindom ◽  
Alberto Rancati ◽  
Claudio Angrigiani
Keyword(s):  
Body Mass Index ◽  
Breast Reconstruction ◽  
Latissimus Dorsi ◽  
Surgical Techniques ◽  
Substantial Body ◽  
Secondary Procedure ◽  
Thoracodorsal Artery ◽  
Muscle Sparing ◽  
Tdap Flap ◽  
Artery Perforator

Thoracodorsal artery (TDA) flaps, ranging from the vascular-pedicled thoracodorsal artery perforator (TDAP) flap, the propeller TDAP flap, and the muscle-sparing latissimus dorsi (MSLD) flap to the conventional latissimus dorsi (LD) flap and the extended LD flap, can all be used for breast reconstruction. The aim of this paper and review is to share our experiences and recommendations for procedure selection when applying TDA-based flaps for breast reconstruction. We describe the different surgical techniques and our thoughts and experience regarding indications and selection between these procedures for individual patients who opt for breast reconstruction. We have performed 574 TDA flaps in 491 patients: 60 extended LD flaps, 122 conventional LD flaps, two MSLD flaps, 233 propeller TDAP flaps, 122 TDAP flaps, and 35 free contralateral TDAP flaps for stacked TDAP breast reconstruction. All the TDA flaps are important flaps for reconstruction of the breast. The LD flap is still an option, although we prefer flaps without muscle when possible. The vascular-pedicled TDAP flap is an option for experienced surgeons, and the propeller TDAP flap can be used in most reconstructive cases of the breast, although a secondary procedure is often necessary for correction of the pedicle bulk. The extended LD flap is an option for women with a substantial body mass index, although it is associated with the highest morbidity of all the TDA flaps. The MSLD flap can be used if the perforators are small or if dissection of the perforators is assessed to be hazardous.

A Retrospective Comparative Analysis of Latissimus Dorsi (LD) Flap Versus Thoracodorsal Artery Perforator (TDAP) Flap in Total Breast Reconstruction with Implants: A Pilot Study

2021 ◽  
Author(s):  
L. Brambilla ◽  
P. Parisi ◽  
A. Gatto ◽  
D. Codazzi ◽  
N. Baronetto ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Breast Reconstruction ◽  
Latissimus Dorsi ◽  
Shoulder Function ◽  
Small Sample ◽  
Dash Score ◽  
Reliable Technique ◽  
Thoracodorsal Artery ◽  
Tdap Flap ◽  
Artery Perforator

Abstract Introduction In breast surgery, an autologous flap combined with implant may reduce the risk or repair the soft-tissue defects in several cases. Traditionally, the preferred flap is the myocutaneous latissimus dorsi (LD) flap. In the perforator flap era, the evolution of LD flap is the thoracodorsal artery perforator (TDAP) flap. The aim of this study is the comparison between LD flap and TDAP flap with implants in terms of early complications and shoulder function. Methods We performed a retrospective cohort study in accordance with the STROBE guidelines. Between January 1 2015 and January 1 2020, 27 women underwent a unilateral total breast reconstruction with LD or TDAP flap combined with an implant at our institution. 15 women were operated with LD flap and 12 with TDAP flap. The most frequent indications for intervention were results of mastectomy and radiation-induced contracture. We evaluated several data in terms of clinical and demographical characteristics, operative and perioperative factors, and follow-up variables. We assessed shoulder function through the Disability of the Arm, Shoulder and Hand Questionnaire (DASH). Results The rate of complications was significantly lower in the TDAP group compared with the LD group (16.7% vs 60.0%, p = 0.047. Table 3). Although the small sample size limited further detailed statistical analyses, we particularly noticed no cases of donor site seroma in the TDAP group, as compared with four in the LD group. Patients in the TDAP group had an ∼11-point lower mean DASH score compared with the LD group (9.8 vs 20.5). This difference was statistically significant (p = 0.049). Conclusions TDAP flap seems to be a reliable technique for soft-tissue coverage in total breast reconstruction with implants. In comparison with the traditional LD flap, it could be a more favorable option in terms of less complications and better quality of life.

Use of the Thoracodorsal Artery Perforator (TDAP) Flap With Implant in Breast Reconstruction

2008 ◽  
Vol 61 (2) ◽  
pp. 143-146 ◽  
Author(s):  
Moustapha Hamdi ◽  
Marzia Salgarello ◽  
Liliana Barone-Adesi ◽  
Koenraad Van Landuyt
Keyword(s):  
Breast Reconstruction ◽  
Thoracodorsal Artery ◽  
Tdap Flap ◽  
Artery Perforator

Pedicled Thoracodorsal Artery Perforator and Muscle-Sparing Latissimus Dorsi Flaps in the Axillary Reconstruction After Hidradenitis Suppurativa Excision

2018 ◽  
Vol 81 (6) ◽  
pp. 694-701 ◽  
Author(s):  
Andrea Marchesi ◽  
Stefano Marcelli ◽  
Nicola Zingaretti ◽  
Pier Camillo Parodi ◽  
Luca Vaienti
Keyword(s):  
Latissimus Dorsi ◽  
Hidradenitis Suppurativa ◽  
Thoracodorsal Artery ◽  
Muscle Sparing ◽  
Artery Perforator ◽  
Latissimus Dorsi Flaps

Thoracodorsal Artery Perforator Flaps and Muscle-Sparing Latissimus Dorsi Myocutaneous Flaps for the Treatment of Axillary Hidradenitis

2012 ◽  
Vol 69 (4) ◽  
pp. 371-375 ◽  
Author(s):  
Shareef Jandali ◽  
Michael N. Mirzabeigi ◽  
Joshua Fosnot ◽  
David W. Low
Keyword(s):  
Latissimus Dorsi ◽  
Perforator Flaps ◽  
Myocutaneous Flaps ◽  
Thoracodorsal Artery ◽  
Muscle Sparing ◽  
Artery Perforator

Breast Reconstruction with the Latissimus Dorsi Flap

2019 ◽  
pp. 677-694
Author(s):  
Michael Klebuc ◽  
Elizabeth Killion ◽  
Jesse Selber ◽  
Gregory R. D. Evans
Keyword(s):  
Breast Reconstruction ◽  
Latissimus Dorsi ◽  
Donor Site ◽  
Perforator Flap ◽  
Donor Site Morbidity ◽  
Thoracodorsal Artery ◽  
Flap Design ◽  
Muscle Sparing ◽  
Endoscopic Assistance ◽  
Thoracodorsal Artery Perforator Flap

Latissimus dorsi muscle and myocutaneous flaps provide a versatile means of providing both implant-based and pure autologous breast reconstructions. The technique is well suited to lean patients and those with contraindications to the use of the lower abdomen as a donor site. The technique has been progressively refined over time to provide concealed scars and to reduce donor site morbidity. The use of endoscopic assistance, robotic flap harvest, muscle-sparing flap design, and perforator flaps based on the thoracodorsal vascular access (the thoracodorsal artery perforator flap or TAP-flap), continue to increase the utility of this donor site for breast reconstruction.

scholarly journals Axillary Reconstruction Using a Pedicled Thoracodorsal Artery Perforator Flap Including Latissimus Dorsi Muscle Strip

2020 ◽  
Vol 16 (1) ◽  
pp. 43-48
Author(s):  
Jin An Cha ◽  
Sung Ho Yoon
Keyword(s):  
Latissimus Dorsi ◽  
Donor Site ◽  
Perforator Flap ◽  
Donor Site Morbidity ◽  
Latissimus Dorsi Muscle ◽  
Muscle Strip ◽  
Dorsi Muscle ◽  
Thoracodorsal Artery ◽  
Tdap Flap ◽  
Artery Perforator

For axillary reconstruction, most reconstructive surgeons use the latissimus dorsi flap because of its usefulness and reliability. However, the latissimus dorsi musculocutaneous flap poses complications such as donor site morbidity and poor aesthetic results. Moreover, the thoracodorsal artery perforator (TDAP) flap, without muscle, presents difficulties for the delicate procedure of dissecting the perforators separately. Therefore, we propose the use of a pedicled TDAP flap including a latissimus dorsi muscle strip for axillary reconstruction, as it is believed to be easier and safer to perform.

Thoracodorsal artery perforator (TDAP) flap in immediate breast reconstruction and the role of preoperative mapping: a clinical experience

2012 ◽  
Vol 36 (3) ◽  
pp. 165-170
Author(s):  
Anna B. Lopez Ojeda ◽  
C. Carrasco Lopez ◽  
Tiago A. Gomes Rodrigues ◽  
J. Muñoz Vidal ◽  
C. Higueras Suñe ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Clinical Experience ◽  
Immediate Breast Reconstruction ◽  
Preoperative Mapping ◽  
Thoracodorsal Artery ◽  
Tdap Flap ◽  
Artery Perforator
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