Abstract

BackgroundThoracodorsal artery perforator (TDAP) flap is one of the relatively new techniques in breast reconstruction. This pedicled flap retains the benefits of perforator flaps as regards minimal donor site morbidity without the need for microvascular anastomosis. Its role in partial breast reconstruction has been well documented. However, there are few reports about the role of this flap in total breast reconstruction.MethodsThis study included 47 cases who presented to the breast unit of the National Cancer Institute of Cairo University from 2013 to 2015. All patients underwent nipple-sparing mastectomy with immediate implant-based reconstruction. The TDAP flap was used to complete the subpectoral pocket for the implants in a way similar to the acellular dermal matrix.ResultsOverall complication rate was 14.9%. Capsular contracture occurred in 6.4%.There were no donor site complications. The majority of patients were satisfied with their cosmetic results. Sixty-eight percent rated their result as “excellent” or “good.”ConclusionThoracodorsal artery perforator flap can play a significant role in total breast reconstruction. In settings with limited resources, this flap can serve as an available autologous alternative to acellular dermal matrix.

Highlights

  • Thoracodorsal artery perforator (TDAP) flap is one of the relatively new techniques in breast reconstruction

  • There were no donor site complications recorded. Patients evaluated their cosmetic outcome as follows in Table 1: BCCT.core20© software showed the following cosmetic results displayed in Table 2: Discussion The main aim of this study was to demonstrate the technical feasibility and outcome of TDAP flap in total breast reconstruction

  • Thoracodorsal artery perforator flap can be safely used in implant-based breast reconstruction

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Summary

Introduction

Thoracodorsal artery perforator (TDAP) flap is one of the relatively new techniques in breast reconstruction. This pedicled flap retains the benefits of perforator flaps as regards minimal donor site morbidity without the need for microvascular anastomosis. In 2008, an estimated 70% of all breast reconstructions performed in the USA were reliant on implants or tissue expanders [1]. This form of reconstruction is popular for its technical feasibility, short recovery, and good esthetic results. It is not associated with donor site morbidity. A biologic material such as the acellular dermal matrix (ADM) is applied to extend the pocket inferiorly and

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