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Background: Application of the thoracodorsal artery perforator (TDAP) flap is known to be a popular and reliable method for extremity reconstruction. This manuscript presents our clinical outcomes in reconstructing soft tissue defects using simple and advanced TDAP flaps.
Methods: From 2013 to 2022, 53 patients with a mean age of 23 years (ranging from 2 to 72 years) underwent reconstructive surgery with different patterns of free TDAP flaps, including chimeric TDAP flaps, double skin paddle TDAP flaps, flow-through TDAP flaps, conjoined TDAP flaps, and microdissected debulking TDAP flaps.
Results: All TDAP flaps survived. The size of the TDAP skin paddle ranged between 5 × 3 and 25 × 10 cm. Primary closure of the donor site was achieved in all patients in the simple application group, and one patient in the advanced application group underwent partial skin grafting. Partial flap loss occurred in one case in the simple TDAP flap group and four cases in the advanced application group. There was one case of flap bulkiness and two cases of scar hyperplasia in the simple TDAP flap group. The mean follow-up duration was 11 months (4-46 months).
Conclusions: The free TDAP flap, with five types of advanced applications, makes it versatile for reconstructing different kinds of soft tissue defects of the extremities that can be used to achieve individualized defect reconstruction, minimize donor site morbidities, and an aesthetic appearance.
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http://dx.doi.org/10.1186/s13018-023-04480-3 | DOI Listing |
Gland Surg
July 2025
Queen Sirikit Centre for Breast Cancer, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Background: Volume replacement after breast-conserving surgery (BCS) can help achieve a good cosmetic outcome, especially in patients with small breast size, where volume displacement is limited. Latissimus dorsi myocutaneous flaps, which are widely used, require a longer hospital stay and have a risk of donor site morbidity. Chest wall perforator flap (CWPF) could be used as an alternative option.
View Article and Find Full Text PDFJ Plast Reconstr Aesthet Surg
September 2025
Department of Plastic and Reconstructive Surgery, Tel Aviv Sourasky Medical Center, Affiliated with Tel Aviv University, Tel Aviv, Israel. Electronic address:
Background: Evolution in breast oncology has increased the use of breast-conserving therapy and expanded the role of locoregional autologous reconstruction. While bilateral reduction is common for patients with large, ptotic breasts, those with small to moderate symmetric breasts often prefer unilateral volume restoration. This study demonstrates a free-style approach to flap selection and design for partial and total breast reconstruction, emphasizing intraoperative decision-making and preservation of muscle and nerve function.
View Article and Find Full Text PDFEur J Breast Health
June 2025
Department of General Surgery, Cairo University Faculty of Medicine, Cairo, Egypt.
Objective: To compare the oncological safety and the cosmetic outcome of the techniques anterior intercostal artery perforator (AICAP), lateral intercostal artery perforator (LICAP) and thoracodorsal artery perforator (TDAP) flap as a volume replacement technique to eliminate deformity and preserve breast cosmesis by filling the excised defect.
Materials And Methods: This prospective study included women with lower outer quadrant, lower inner quadrant, and upper outer quadrant tumors who underwent upfront or post-neoadjuvant chemotherapy breast conserving surgery with immediate volume replacement surgery. Patients were allocated into three groups at a ratio of 1:1: Group A ( = 10): women who underwent LICAP flap, group B ( = 10): Women who underwent AICAP, and group C ( = 10): Women who underwent TDAP flap procedures.
Plast Reconstr Surg
May 2025
Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Background: Reconstruction of shallow but complicated defects with exposed critical structures often requires vascularized tissue with skin-like thinness, which pure-skin-perforator flaps can provide. Despite their benefits, pure-skin-perforator flaps are underutilized due to remained uncertainties surrounding their application. This study reviews our experience with free pure-skin-perforator flap reconstruction, focusing on the elevation process, donor site selection, and clinical outcomes.
View Article and Find Full Text PDFMinerva Surg
June 2025
Burn & Plastic Department, Reconstructive and Esthetic Surgery, Azienda Ospedaliera Cannizzaro, Catania, Italy.
Introduction: Breast-conserving surgery (BCS) is often the first-line treatment for early-stage invasive breast cancer. Many studies claim that survival is non-inferior to radical treatments in selected cases. Although BCS preserves some breast tissue and often the nipple-areola complex, asymmetry and distortion of the breast contour may occur and reconstruction is sometimes required.
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