Thoracodorsal Artery Perforator and Superior Epigastric Artery Perforator Flaps for Volume Replacement Oncoplastic Breast Surgery
Introduction Breast conservation therapy (BCT) and oncoplastic breast surgery (OBS) are now established modalities of treatment for breast cancer, with proven oncological safety. Traditionally, latissimus dorsi (LD) flaps have been the one-stop solution workhorse when volume replacement is needed. W...
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doaj-57c585dc3e29434c98e9fa43e13a35ee2020-11-25T03:40:38ZengThieme Medical Publishers, Inc.Indian Journal of Plastic Surgery0970-03581998-376X2019-09-01520330430810.1055/s-0039-3400688Thoracodorsal Artery Perforator and Superior Epigastric Artery Perforator Flaps for Volume Replacement Oncoplastic Breast SurgeryDushyant Jaiswal0Prabha Subhash Yadav1Vinay Kant Shankhdhar2Tasneem Jaffer Belgaumwala3Department of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, IndiaDepartment of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, IndiaDepartment of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, IndiaDepartment of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, IndiaIntroduction Breast conservation therapy (BCT) and oncoplastic breast surgery (OBS) are now established modalities of treatment for breast cancer, with proven oncological safety. Traditionally, latissimus dorsi (LD) flaps have been the one-stop solution workhorse when volume replacement is needed. We present our experience with thoracodorsal artery perforator (TDAP) and superior epigastric artery perforator (SEAP) flaps. These flaps allow the preservation of muscle structure and function. Material and Methods Data were collected prospectively of patients in whom pedicled perforator flaps after BCT were used. A handheld 8-MHz audio Doppler was used to locate the perforators. TDAP flaps were used in four patients, whereas SEAP flaps were used in two patients. Skin paddle sizes ranged from 10 × 3 cm to 21 × 7 cm. Results TDAP flaps were used in four patients, whereas SEAP flaps were used in two patients All flaps survived. No flap had partial necrosis or fat necrosis. All donor sites were closed primarily and healed uneventfully, and none had a seroma requiring aspiration. Conclusion TDAP flaps can be selectively employed when the LD muscle function needs to be preserved. SEAP flaps can also be employed as a rare option in case of lower inner quadrant defects. Pedicled perforator flaps are a useful and reliable option for volume replacement OBS in select patients for reconstructing partial mastectomy defects.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-3400688oncoplastic breast surgeryvolume replacementbreast conservation therapypartial breast reconstructionperforator flapstdapseap |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Dushyant Jaiswal Prabha Subhash Yadav Vinay Kant Shankhdhar Tasneem Jaffer Belgaumwala |
spellingShingle |
Dushyant Jaiswal Prabha Subhash Yadav Vinay Kant Shankhdhar Tasneem Jaffer Belgaumwala Thoracodorsal Artery Perforator and Superior Epigastric Artery Perforator Flaps for Volume Replacement Oncoplastic Breast Surgery Indian Journal of Plastic Surgery oncoplastic breast surgery volume replacement breast conservation therapy partial breast reconstruction perforator flaps tdap seap |
author_facet |
Dushyant Jaiswal Prabha Subhash Yadav Vinay Kant Shankhdhar Tasneem Jaffer Belgaumwala |
author_sort |
Dushyant Jaiswal |
title |
Thoracodorsal Artery Perforator and Superior Epigastric Artery Perforator Flaps for Volume Replacement Oncoplastic Breast Surgery |
title_short |
Thoracodorsal Artery Perforator and Superior Epigastric Artery Perforator Flaps for Volume Replacement Oncoplastic Breast Surgery |
title_full |
Thoracodorsal Artery Perforator and Superior Epigastric Artery Perforator Flaps for Volume Replacement Oncoplastic Breast Surgery |
title_fullStr |
Thoracodorsal Artery Perforator and Superior Epigastric Artery Perforator Flaps for Volume Replacement Oncoplastic Breast Surgery |
title_full_unstemmed |
Thoracodorsal Artery Perforator and Superior Epigastric Artery Perforator Flaps for Volume Replacement Oncoplastic Breast Surgery |
title_sort |
thoracodorsal artery perforator and superior epigastric artery perforator flaps for volume replacement oncoplastic breast surgery |
publisher |
Thieme Medical Publishers, Inc. |
series |
Indian Journal of Plastic Surgery |
issn |
0970-0358 1998-376X |
publishDate |
2019-09-01 |
description |
Introduction Breast conservation therapy (BCT) and oncoplastic breast surgery (OBS) are now established modalities of treatment for breast cancer, with proven oncological safety. Traditionally, latissimus dorsi (LD) flaps have been the one-stop solution workhorse when volume replacement is needed. We present our experience with thoracodorsal artery perforator (TDAP) and superior epigastric artery perforator (SEAP) flaps. These flaps allow the preservation of muscle structure and function.
Material and Methods Data were collected prospectively of patients in whom pedicled perforator flaps after BCT were used. A handheld 8-MHz audio Doppler was used to locate the perforators. TDAP flaps were used in four patients, whereas SEAP flaps were used in two patients. Skin paddle sizes ranged from 10 × 3 cm to 21 × 7 cm.
Results TDAP flaps were used in four patients, whereas SEAP flaps were used in two patients All flaps survived. No flap had partial necrosis or fat necrosis. All donor sites were closed primarily and healed uneventfully, and none had a seroma requiring aspiration.
Conclusion TDAP flaps can be selectively employed when the LD muscle function needs to be preserved. SEAP flaps can also be employed as a rare option in case of lower inner quadrant defects. Pedicled perforator flaps are a useful and reliable option for volume replacement OBS in select patients for reconstructing partial mastectomy defects. |
topic |
oncoplastic breast surgery volume replacement breast conservation therapy partial breast reconstruction perforator flaps tdap seap |
url |
http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-3400688 |
work_keys_str_mv |
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