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Clinical Application Of The Thoradorsal Artery Perforator Flaps
Xiancheng Wang, Sr., Ph.D.&M.D..
Department of Plastic Surgery and Aesthetic Surgery and Burns, Second XiangYa Hospital, Xiangya Medical School, Central South Unverisity, Hunan, China.

PURPOSE:
Thoracdorsal artery perforator flaps without latissimus dorsi muscle - have been used for reconstruction of the extremities, head and neck as free style flaps, and as pedicled flaps for reconstruction of chest wall and axillary wounds. This restrospective study aimed to analyze the clinical applications and relevant anatomic findings of thoradorsal artery perforator (TAP) flaps.
METHODS:
From April 2007 to August 2011, 67 free or pedicled TAP flaps were transferred in 67 patients for reconstruction of wounds of the extremities, chest wall and axilla. Eight were used as free flaps for reconstruction of extremities, and 59 used as pedicled flaps for reconstruction of axillary or chest wounds. Patient ages ranged from 7 to 55 years old(26.04±12.83). Perforator arteries were detected and idetified with a hand held Doppler. The size of flaps ranged from 6cm by 9cm to 14cm by 18cm((8.66±2.05) by (12.62±2.03)). Flaps were designed with the perforator artery included, with all flaps based on one or two perforator arteries.
RESULTS:
All of the flaps survived. There were no problems with vascular spasm or occlusion. Significant venous congestion was not observed in any of the cases. Two cases developed minor wound dehiscence but healed with conservative therapy. None of the donor sites developed seromas.
CONCLUSION:
The thoradorsal artery flap without associated latissimus dorsi muscle can provide a thin, large and reliable flap with robust blood supply. The TAP flap can significantly reduce donor site morbidity.


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