Thoracodorsal artery flaps for breast reconstruction–the variants and its approach
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 reconstru...
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Published in | Archives of plastic surgery Vol. 48; no. 1; pp. 15 - 25 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
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Thieme Medical Publishers, Inc
01.01.2021
Korean Society of Plastic and Reconstructive Surgeons 대한성형외과학회 |
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Abstract | 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. |
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AbstractList | 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. 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. KCI Citation Count: 0 |
Author | Rindom, Mikkel Børsen Rancati, Alberto Thomsen, Jørn Bo Angrigiani, Claudio |
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Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 We would like to acknowledge Caroline Lilja for drawing the illustrations of the different types of thoracodorsal artery flaps. https://doi.org/10.5999/aps.2020.01410 |
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reconstruction: a simplified surgical technique publication-title: J Plast Reconstr Aesthet Surg doi: 10.1016/j.bjps.2018.05.008 contributor: fullname: GL Gunnarsson – volume: 03 start-page: e435 year: 2015 ident: ref25 article-title: Bilateral breast reconstruction with extended thoracodorsal artery perforator propeller flaps and implants publication-title: Plast Reconstr Surg Glob Open doi: 10.1097/GOX.0000000000000414 contributor: fullname: GL Gunnarsson – volume: 41 start-page: 24 year: 2008 ident: ref20 article-title: The extended latissimus dorsi flap option in autologous breast reconstruction: a report of 14 cases and review of the literature publication-title: Indian J Plast Surg doi: 10.4103/0970-0358.41107 contributor: fullname: MA Rifaat |
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SubjectTerms | breast Breast/Trunk education, medical keywords surgical flaps 성형외과학 |
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Title | Thoracodorsal artery flaps for breast reconstruction–the variants and its approach |
URI | http://dx.doi.org/10.5999/aps.2020.01410 https://www.ncbi.nlm.nih.gov/pubmed/33503740 https://search.proquest.com/docview/2482669874 https://pubmed.ncbi.nlm.nih.gov/PMC7861974 https://doaj.org/article/6bab81cb0eb94818910a351e7e4b1209 https://www.kci.go.kr/kciportal/ci/sereArticleSearch/ciSereArtiView.kci?sereArticleSearchBean.artiId=ART002678482 |
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ispartofPNX | Archives of Plastic Surgery, 2021, 48(1), , pp.15-25 |
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