The combined transverse upper gracilis and profunda artery perforator (TUGPAP) flap for breast reconstruction
Background Surgical options for breast reconstruction include alloplastic and autogenous reconstructions. In autologous cases where the abdomen is not a suitable primary donor site, secondary donor sites such as the thigh or buttock are considered. The aim of this report is to describe a novel appro...
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| Published in | Microsurgery Vol. 36; no. 5; pp. 359 - 366 |
|---|---|
| Main Authors | , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Blackwell Publishing Ltd
01.07.2016
Wiley Subscription Services, Inc |
| Online Access | Get full text |
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| Abstract | Background
Surgical options for breast reconstruction include alloplastic and autogenous reconstructions. In autologous cases where the abdomen is not a suitable primary donor site, secondary donor sites such as the thigh or buttock are considered. The aim of this report is to describe a novel approach, the combined transverse upper gracilis and profunda artery perforator (TUGPAP) flap, aimed at medium to large volume breast reconstruction, with a single donor site used per breast.
Methods
Between January 2011 and June 2013, 32 consecutive unilateral immediate breast reconstruction cases were performed using free flaps. In nine cases, patients had previously undergone abdominal surgery, therefore abdominal flaps were excluded and TUGPAP flaps were performed. The TUGPAP flap consisted of the combination of two well‐described flaps: the transverse upper gracilis (TUG) and the profunda artery perforator (PAP) flap. All TUGPAP flaps were based on two pedicles: the ascending branch of the medial circumflex femoral artery (MCFA) for the TUG component, and the profunda artery perforator itself for the PAP component.
Results
The mean size of the harvested skin paddle was 28.6 × 8 cm2 (range, 27 × 7 cm2 to 30 × 9 cm2). The average length of the TUG flap pedicle was 7 cm (range, 6–8 cm) and the PAP flap pedicle was 9 cm (range, 8.5–10 cm). The flap survival rate was 100% with no re‐exploration, and no partial flap loss. Post‐operatively there was one case of persistent donor site seroma, which was managed conservatively.
Conclusion
With appropriate patient selection and surgical technique the TUGPAP flap could be a valuable option as an alternative method for autologous breast reconstruction. © 2015 Wiley Periodicals, Inc. Microsurgery 36:359–366, 2016. |
|---|---|
| AbstractList | Background
Surgical options for breast reconstruction include alloplastic and autogenous reconstructions. In autologous cases where the abdomen is not a suitable primary donor site, secondary donor sites such as the thigh or buttock are considered. The aim of this report is to describe a novel approach, the combined transverse upper gracilis and profunda artery perforator (TUGPAP) flap, aimed at medium to large volume breast reconstruction, with a single donor site used per breast.
Methods
Between January 2011 and June 2013, 32 consecutive unilateral immediate breast reconstruction cases were performed using free flaps. In nine cases, patients had previously undergone abdominal surgery, therefore abdominal flaps were excluded and TUGPAP flaps were performed. The TUGPAP flap consisted of the combination of two well‐described flaps: the transverse upper gracilis (TUG) and the profunda artery perforator (PAP) flap. All TUGPAP flaps were based on two pedicles: the ascending branch of the medial circumflex femoral artery (MCFA) for the TUG component, and the profunda artery perforator itself for the PAP component.
Results
The mean size of the harvested skin paddle was 28.6 × 8 cm2 (range, 27 × 7 cm2 to 30 × 9 cm2). The average length of the TUG flap pedicle was 7 cm (range, 6–8 cm) and the PAP flap pedicle was 9 cm (range, 8.5–10 cm). The flap survival rate was 100% with no re‐exploration, and no partial flap loss. Post‐operatively there was one case of persistent donor site seroma, which was managed conservatively.
Conclusion
With appropriate patient selection and surgical technique the TUGPAP flap could be a valuable option as an alternative method for autologous breast reconstruction. © 2015 Wiley Periodicals, Inc. Microsurgery 36:359–366, 2016. Background Surgical options for breast reconstruction include alloplastic and autogenous reconstructions. In autologous cases where the abdomen is not a suitable primary donor site, secondary donor sites such as the thigh or buttock are considered. The aim of this report is to describe a novel approach, the combined transverse upper gracilis and profunda artery perforator (TUGPAP) flap, aimed at medium to large volume breast reconstruction, with a single donor site used per breast. Methods Between January 2011 and June 2013, 32 consecutive unilateral immediate breast reconstruction cases were performed using free flaps. In nine cases, patients had previously undergone abdominal surgery, therefore abdominal flaps were excluded and TUGPAP flaps were performed. The TUGPAP flap consisted of the combination of two well-described flaps: the transverse upper gracilis (TUG) and the profunda artery perforator (PAP) flap. All TUGPAP flaps were based on two pedicles: the ascending branch of the medial circumflex femoral artery (MCFA) for the TUG component, and the profunda artery perforator itself for the PAP component. Results The mean size of the harvested skin paddle was 28.6 × 8 cm2 (range, 27 × 7 cm2 to 30 × 9 cm2). The average length of the TUG flap pedicle was 7 cm (range, 6-8 cm) and the PAP flap pedicle was 9 cm (range, 8.5-10 cm). The flap survival rate was 100% with no re-exploration, and no partial flap loss. Post-operatively there was one case of persistent donor site seroma, which was managed conservatively. Conclusion With appropriate patient selection and surgical technique the TUGPAP flap could be a valuable option as an alternative method for autologous breast reconstruction. © 2015 Wiley Periodicals, Inc. Microsurgery 36:359-366, 2016. Surgical options for breast reconstruction include alloplastic and autogenous reconstructions. In autologous cases where the abdomen is not a suitable primary donor site, secondary donor sites such as the thigh or buttock are considered. The aim of this report is to describe a novel approach, the combined transverse upper gracilis and profunda artery perforator (TUGPAP) flap, aimed at medium to large volume breast reconstruction, with a single donor site used per breast.BACKGROUNDSurgical options for breast reconstruction include alloplastic and autogenous reconstructions. In autologous cases where the abdomen is not a suitable primary donor site, secondary donor sites such as the thigh or buttock are considered. The aim of this report is to describe a novel approach, the combined transverse upper gracilis and profunda artery perforator (TUGPAP) flap, aimed at medium to large volume breast reconstruction, with a single donor site used per breast.Between January 2011 and June 2013, 32 consecutive unilateral immediate breast reconstruction cases were performed using free flaps. In nine cases, patients had previously undergone abdominal surgery, therefore abdominal flaps were excluded and TUGPAP flaps were performed. The TUGPAP flap consisted of the combination of two well-described flaps: the transverse upper gracilis (TUG) and the profunda artery perforator (PAP) flap. All TUGPAP flaps were based on two pedicles: the ascending branch of the medial circumflex femoral artery (MCFA) for the TUG component, and the profunda artery perforator itself for the PAP component.METHODSBetween January 2011 and June 2013, 32 consecutive unilateral immediate breast reconstruction cases were performed using free flaps. In nine cases, patients had previously undergone abdominal surgery, therefore abdominal flaps were excluded and TUGPAP flaps were performed. The TUGPAP flap consisted of the combination of two well-described flaps: the transverse upper gracilis (TUG) and the profunda artery perforator (PAP) flap. All TUGPAP flaps were based on two pedicles: the ascending branch of the medial circumflex femoral artery (MCFA) for the TUG component, and the profunda artery perforator itself for the PAP component.The mean size of the harvested skin paddle was 28.6 × 8 cm2 (range, 27 × 7 cm2 to 30 × 9 cm2). The average length of the TUG flap pedicle was 7 cm (range, 6-8 cm) and the PAP flap pedicle was 9 cm (range, 8.5-10 cm). The flap survival rate was 100% with no re-exploration, and no partial flap loss. Post-operatively there was one case of persistent donor site seroma, which was managed conservatively.RESULTSThe mean size of the harvested skin paddle was 28.6 × 8 cm2 (range, 27 × 7 cm2 to 30 × 9 cm2). The average length of the TUG flap pedicle was 7 cm (range, 6-8 cm) and the PAP flap pedicle was 9 cm (range, 8.5-10 cm). The flap survival rate was 100% with no re-exploration, and no partial flap loss. Post-operatively there was one case of persistent donor site seroma, which was managed conservatively.With appropriate patient selection and surgical technique the TUGPAP flap could be a valuable option as an alternative method for autologous breast reconstruction. © 2015 Wiley Periodicals, Inc. Microsurgery, 2015.CONCLUSIONWith appropriate patient selection and surgical technique the TUGPAP flap could be a valuable option as an alternative method for autologous breast reconstruction. © 2015 Wiley Periodicals, Inc. Microsurgery, 2015. Surgical options for breast reconstruction include alloplastic and autogenous reconstructions. In autologous cases where the abdomen is not a suitable primary donor site, secondary donor sites such as the thigh or buttock are considered. The aim of this report is to describe a novel approach, the combined transverse upper gracilis and profunda artery perforator (TUGPAP) flap, aimed at medium to large volume breast reconstruction, with a single donor site used per breast. Between January 2011 and June 2013, 32 consecutive unilateral immediate breast reconstruction cases were performed using free flaps. In nine cases, patients had previously undergone abdominal surgery, therefore abdominal flaps were excluded and TUGPAP flaps were performed. The TUGPAP flap consisted of the combination of two well-described flaps: the transverse upper gracilis (TUG) and the profunda artery perforator (PAP) flap. All TUGPAP flaps were based on two pedicles: the ascending branch of the medial circumflex femoral artery (MCFA) for the TUG component, and the profunda artery perforator itself for the PAP component. The mean size of the harvested skin paddle was 28.6 × 8 cm (range, 27 × 7 cm to 30 × 9 cm ). The average length of the TUG flap pedicle was 7 cm (range, 6-8 cm) and the PAP flap pedicle was 9 cm (range, 8.5-10 cm). The flap survival rate was 100% with no re-exploration, and no partial flap loss. Post-operatively there was one case of persistent donor site seroma, which was managed conservatively. With appropriate patient selection and surgical technique the TUGPAP flap could be a valuable option as an alternative method for autologous breast reconstruction. © 2015 Wiley Periodicals, Inc. Microsurgery, 2015. Background Surgical options for breast reconstruction include alloplastic and autogenous reconstructions. In autologous cases where the abdomen is not a suitable primary donor site, secondary donor sites such as the thigh or buttock are considered. The aim of this report is to describe a novel approach, the combined transverse upper gracilis and profunda artery perforator (TUGPAP) flap, aimed at medium to large volume breast reconstruction, with a single donor site used per breast. Methods Between January 2011 and June 2013, 32 consecutive unilateral immediate breast reconstruction cases were performed using free flaps. In nine cases, patients had previously undergone abdominal surgery, therefore abdominal flaps were excluded and TUGPAP flaps were performed. The TUGPAP flap consisted of the combination of two well-described flaps: the transverse upper gracilis (TUG) and the profunda artery perforator (PAP) flap. All TUGPAP flaps were based on two pedicles: the ascending branch of the medial circumflex femoral artery (MCFA) for the TUG component, and the profunda artery perforator itself for the PAP component. Results The mean size of the harvested skin paddle was 28.6 8 cm super(2) (range, 27 7 cm super(2) to 30 9 cm super(2)). The average length of the TUG flap pedicle was 7 cm (range, 6-8 cm) and the PAP flap pedicle was 9 cm (range, 8.5-10 cm). The flap survival rate was 100% with no re-exploration, and no partial flap loss. Post-operatively there was one case of persistent donor site seroma, which was managed conservatively. Conclusion With appropriate patient selection and surgical technique the TUGPAP flap could be a valuable option as an alternative method for autologous breast reconstruction. Microsurgery 36:359-366, 2016. |
| Author | Lin, Shu-Ping Ciudad, Pedro Sirimahachaiyakul, Pornthep Weng, Hui-Ching Sapountzis, Stamatis Wang, Gou-Jen Socas, Juan Kiranantawat, Kidakorn Chen, Hung-Chi Cigna, Emanuele Orfaniotis, Georgios Maruccia, Michele Nicoli, Fabio Constantinescu, Thomas |
| Author_xml | – sequence: 1 givenname: Pedro surname: Ciudad fullname: Ciudad, Pedro organization: Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan – sequence: 2 givenname: Michele surname: Maruccia fullname: Maruccia, Michele organization: Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan – sequence: 3 givenname: Georgios surname: Orfaniotis fullname: Orfaniotis, Georgios organization: Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan – sequence: 4 givenname: Hui-Ching surname: Weng fullname: Weng, Hui-Ching organization: Institute of Gerontology, College Of Medicine, Cheng Kung Kung University, Tainan, Taiwan – sequence: 5 givenname: Thomas surname: Constantinescu fullname: Constantinescu, Thomas organization: Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan – sequence: 6 givenname: Fabio surname: Nicoli fullname: Nicoli, Fabio organization: Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan – sequence: 7 givenname: Emanuele surname: Cigna fullname: Cigna, Emanuele organization: Department of Plastic Surgery, Reconstructive and Aesthetic Surgery, 'Sapienza' University, Rome, Italy – sequence: 8 givenname: Juan surname: Socas fullname: Socas, Juan organization: Department of Plastic and Reconstructive Surgery, Indiana University School of Medicine, Indianapolis, USA – sequence: 9 givenname: Pornthep surname: Sirimahachaiyakul fullname: Sirimahachaiyakul, Pornthep organization: Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan – sequence: 10 givenname: Stamatis surname: Sapountzis fullname: Sapountzis, Stamatis organization: Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan – sequence: 11 givenname: Kidakorn surname: Kiranantawat fullname: Kiranantawat, Kidakorn organization: Division of Plastic and Maxillofacial Surgery, Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand – sequence: 12 givenname: Shu-Ping surname: Lin fullname: Lin, Shu-Ping organization: Graduate Institute of Biomedical Engineering, National Chung Hsing University, Taichung, Taiwan – sequence: 13 givenname: Gou-Jen surname: Wang fullname: Wang, Gou-Jen email: gjwang@dragon.nchu.edu.tw organization: PhD Program in Tissue Engineering and Regenerative Medicine, National Chung Hsing University, Taichung, Taiwan – sequence: 14 givenname: Hung-Chi surname: Chen fullname: Chen, Hung-Chi email: gjwang@dragon.nchu.edu.tw organization: Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan |
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Surgical options for breast reconstruction include alloplastic and autogenous reconstructions. In autologous cases where the abdomen is not a... Surgical options for breast reconstruction include alloplastic and autogenous reconstructions. In autologous cases where the abdomen is not a suitable primary... Background Surgical options for breast reconstruction include alloplastic and autogenous reconstructions. In autologous cases where the abdomen is not a... |
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| Title | The combined transverse upper gracilis and profunda artery perforator (TUGPAP) flap for breast reconstruction |
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