Unveiling the versatility of pedicled thoracodorsal artery perforator flap with a modified surgical technique for excellent outcome.

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Author(s): Muhammad Omar Afzal1, Sadia Hussain2, Umer Nazir3, Aroobah Iqbal4, Umar Asif5, Hafsa khalid6

Received: 10/07/2024 | Revised: 01/09/2024 | Published: 04/09/2024 | Pages: 61-65 | DOI: https://www.ejmanager.com/mnstemps/249/249-1720589785.pdf?t=1763792562


Background: The thoracodorsal artery perforator (TDAP) flap has attracted considerable interest in reconstructive surgery owing to its reliable vascular supply and adaptability. It is an excellent fasciocutaneous flap but hasn’t gain much acceptance due to variable outcome.

Objective: The aim of the study is to analyze the use of the pedicled thoracodorsal artery perforator flap with description of an easy and reproducible technique of flap raising with good outcome.

Methodology:

This case series was conducted at Plastic Surgery Department, Mayo Hospital Lahore / King Edward Medical University from November, 2022 to November, 2023. Patients requiring coverage of defects on back, shoulder, axilla and chest were included. The antigrade approach was adopted to raise the flap and cover the defect. The patients’ demographics, defect characteristics, surgical details, and postoperative outcomes were systematically analyzed. The primary outcomes included flap survival, donor site scarring and functional outcomes of latissmus dorsi muscle.

Results:

Total 30 patients were included in the study. 5 cases were of inframammary fold contracture, 9 cases of axillary fold contracture, 5 cases were post tumour resection defect tumor and 1 had post traumatic soft tissue defect. Complete flap survival was noted in 29 cases, with partial necrosis in one flap due to venous congestion secondary to hematoma formation. None of the patients developed any scar related complication at donor site. None of the patients developed functional compromise of LD muscle.

Conclusion:

The antegrade approach is an easy and reproducible technique to raise TDAP flap to reconstruct wide range of defects.

Key words: Thoracodorsal artery perforator (TDAP) flap, IMF contracture, Antegrade Approach.