Clinical Application of the Internal Mammary Artery Perforator Adipofascial Flap
Background:. Skin ulcers on the anterior chest wall are caused mainly by radiation therapy for breast cancer and anterior mediastinitis after thoracotomy, and they are often refractory. Some muscle flaps are commonly used for anterior chest wall reconstruction, but muscle flaps accompany high invasi...
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2019-03-01
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doaj-b01206eca4c44cd8b1854409aad4ca192020-11-24T20:41:57ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742019-03-0173e206210.1097/GOX.0000000000002062201903000-00016Clinical Application of the Internal Mammary Artery Perforator Adipofascial FlapMari Nishimon, MD0Hirotoshi Ohara, MD1Kanetoshi Ohara, MD2Hisao Ogata, MD3Kazuo Kishi, MD4From the *Department of Plastic and Reconstructive Surgery, Keio University, Shinjuku-ku, Tokyo†Department of Plastic and Reconstructive Surgery, National Hospital Organization Saitama Hospital, Wako-shi, Saitama‡Ohara Orthopedic and Plastic Surgery, Kawaguchi-shi, Saitama†Department of Plastic and Reconstructive Surgery, National Hospital Organization Saitama Hospital, Wako-shi, SaitamaFrom the *Department of Plastic and Reconstructive Surgery, Keio University, Shinjuku-ku, TokyoBackground:. Skin ulcers on the anterior chest wall are caused mainly by radiation therapy for breast cancer and anterior mediastinitis after thoracotomy, and they are often refractory. Some muscle flaps are commonly used for anterior chest wall reconstruction, but muscle flaps accompany high invasion. We used the internal mammary artery perforator (IMAP) adipofascial flap and IMAP skin flap for the anterior chest wall reconstruction. Methods:. We examined the IMAPs using a handheld Doppler device and contrast-enhanced computerized tomography preoperatively. Each flap was designed based on the location of the IMAP and the size of the flap was dependent on the coverage required by the size and location of the skin ulcer. The location of the IMAPs functioned as the pivot point of the flap and the flap was flipped or swung on the defect. Results:. We used IMAP adipofascial flap for 2 cases and IMAP skin flap for 1 case. In those 3 cases, we could elevate the flap with no complications even after the internal mammary artery had been harvested. There was no recurrence of the skin ulcer or wound infection after the operation. Conclusions:. In this study, we reported 3 cases of skin ulcer on the anterior chest wall reconstructed with the IMAP adipofascial and skin flap. To our knowledge, this is the first report of the use of the IMAP flap as an adipofascial flap. The IMAP adipofascial flap accompanies less invasion than muscle flaps and the surgical procedure is relatively easy. The IMAP adopofascial flap is considered as one of the effective means for anterior chest wall reconstruction.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000002062 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mari Nishimon, MD Hirotoshi Ohara, MD Kanetoshi Ohara, MD Hisao Ogata, MD Kazuo Kishi, MD |
spellingShingle |
Mari Nishimon, MD Hirotoshi Ohara, MD Kanetoshi Ohara, MD Hisao Ogata, MD Kazuo Kishi, MD Clinical Application of the Internal Mammary Artery Perforator Adipofascial Flap Plastic and Reconstructive Surgery, Global Open |
author_facet |
Mari Nishimon, MD Hirotoshi Ohara, MD Kanetoshi Ohara, MD Hisao Ogata, MD Kazuo Kishi, MD |
author_sort |
Mari Nishimon, MD |
title |
Clinical Application of the Internal Mammary Artery Perforator Adipofascial Flap |
title_short |
Clinical Application of the Internal Mammary Artery Perforator Adipofascial Flap |
title_full |
Clinical Application of the Internal Mammary Artery Perforator Adipofascial Flap |
title_fullStr |
Clinical Application of the Internal Mammary Artery Perforator Adipofascial Flap |
title_full_unstemmed |
Clinical Application of the Internal Mammary Artery Perforator Adipofascial Flap |
title_sort |
clinical application of the internal mammary artery perforator adipofascial flap |
publisher |
Wolters Kluwer |
series |
Plastic and Reconstructive Surgery, Global Open |
issn |
2169-7574 |
publishDate |
2019-03-01 |
description |
Background:. Skin ulcers on the anterior chest wall are caused mainly by radiation therapy for breast cancer and anterior mediastinitis after thoracotomy, and they are often refractory. Some muscle flaps are commonly used for anterior chest wall reconstruction, but muscle flaps accompany high invasion. We used the internal mammary artery perforator (IMAP) adipofascial flap and IMAP skin flap for the anterior chest wall reconstruction.
Methods:. We examined the IMAPs using a handheld Doppler device and contrast-enhanced computerized tomography preoperatively. Each flap was designed based on the location of the IMAP and the size of the flap was dependent on the coverage required by the size and location of the skin ulcer. The location of the IMAPs functioned as the pivot point of the flap and the flap was flipped or swung on the defect.
Results:. We used IMAP adipofascial flap for 2 cases and IMAP skin flap for 1 case. In those 3 cases, we could elevate the flap with no complications even after the internal mammary artery had been harvested. There was no recurrence of the skin ulcer or wound infection after the operation.
Conclusions:. In this study, we reported 3 cases of skin ulcer on the anterior chest wall reconstructed with the IMAP adipofascial and skin flap. To our knowledge, this is the first report of the use of the IMAP flap as an adipofascial flap. The IMAP adipofascial flap accompanies less invasion than muscle flaps and the surgical procedure is relatively easy. The IMAP adopofascial flap is considered as one of the effective means for anterior chest wall reconstruction. |
url |
http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000002062 |
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