Versatility of the Pedicled Thoracodorsal Artery Perforator Flap (TDAP) Anatomic Basis and Clinical Application in breast reconstruction

Abstract

Background: the thoracodorsal artery perforator (TDAP) flap is relatively new member of perforator flap family in reconstructive surgery. TDAP flap used as pedicled flap in breast reconstruction. Advantages of the TDAP flap include homogenous flap thickness, minimal donor-site morbidity, and constant vascular anatomy with a long pedicle. Aim: to study versatility of the pedicled thoracodorsal artery perforator flap and evaluate its role in breast reconstruction. Methods: This prospective cohort study was conducted in Zagazig university Hospitals during the period from January 2018 till January 2019 on 20 patients with breast cancer who have been subjected to breast surgery and immediate breast reconstruction. Results: the mean time taken for flap elevation was 266 ± 18 minutes, flap elevated with single perforator in 85 % of the cases and with double perforators in the remaining 15%. The mean skin paddle diameters were 15.6 ± 3.3 cm in length and 7.2 ± 2.1 cm width. The donor side was closed by primary closure in 90% while two cases (10%) needed grafting for closure. Objective and subjective assessment for the post procedure satisfaction showed that around 90% of the population was satisfied by the result. Conclusion: The TDAP has several advantages that make it a work horse for many soft tissue reconstructions in appropriately selected patients. The drawback of the TDAP can be manipulated by some technical modification.