Pedicled Thoracodorsal Artery Perforator Flap to Resurface Locoregional Soft Tissue Defects-A Prospective Study PC01-PC04
Dr. Prabir Kumar Jash,
Department of Plastic and Reconstructive Surgery, Medical College and Hospital, 88 College Street, Kolkata-700073, West Bengal, India.
Introduction: Soft tissue defects of different etiopathologies over axilla, breast, upper arm and shoulder entail resurfacing with thin and pliable tissue coverage, with good colour and consistency match and minimum donor site morbidity. Previously Latissimus Dorsi Muscle or Myocutaneous flap (LDMC) were the main option for pedicled tissue transfer to those defects. With evaluation and refinement of the perforator and perforosome concept in reconstructive surgery, the Thoracodorsal Artery Perforator (TDAP) flap has taken up an important role replacing LDMC.
Aim: To study the versatility of TDAP in soft tissue defects of different etiopathologies and regions and the post-operative complications.
Materials and Methods: A prospective study was conducted on 12 patients (3 males/9 females) with post traumatic or post excisional soft tissue defects in anterior chest wall, breast, neck, axilla and arm with various pathologies over a period of two years. Patients were chosen as per inclusion criteria, informed consents were taken with institutional ethical clearance, pre-operative planning was done, intra-operative and post-operative results were documented and analysed.
Results: Out of 12 cases, the recipient sites were breast in 42% cases and axilla in another 42%. Soft tissue defects following post tumour resection constituted 33% of the cases, 84% flaps survived, septocutaneous perforators (58%) were predominant, primary closure of the donor site was successful in 75% of the cases with scar widening of the upper back (donor area) seen as the most common complication in 50% of the cases.
Conclusion: TDAP as a pedicled flap is a versatile flap for resurfacing loco-regional soft tissue defects of different etiologies. Also a durable, thin, pliable skin cover is obtained with excellent cosmesis.