Pedicled thoracodorsal artery perforator flap in breast reconstruction: clinical experience.
BACKGROUND
The thoracodorsal artery perforator (TDAP) flap has been described for reconstruction of the head and neck, trunk and extremities. Yet, its use as a pedicled flap in breast reconstruction has not gained wide popularity and has not been widely documented, especially not for complete breast reconstruction or in combination with expanders or permanent implants. The authors present their clinical experience with the thoracodorsal artery perforator flap in breast reconstruction.


METHODS
From February 2007 to February 2009, eighteen patients had breast reconstruction utilizing a TDAP flap. Retrospective analyzes of patient characteristics, breast history, clinical indications, complications and outcomes were performed. The follow-up period ranged from 1 to 17 months.


RESULTS
Eleven patients had complete breast reconstruction using a TDAP flap with simultaneous insertion of an expander or implant. Four cases were partial reconstruction to gain additional volume after previous breast reconstruction and the 3 other cases were reconstruction after lumpectomy. All flaps survived. Two case required evacuation of hematoma. One case had late extrusion of the expander after expansion in the previously irradiated tissue, requiring expander removal. There were no donor site complications.


CONCLUSIONS
The TDAP flap has proven to be a reliable flap with minimal donor site morbidity. Patients who had radiation treatment prior to reconstruction with pronounced radiated chest skin changes might still benefit from additional tissue from the LD muscle.
Adler
Neta
N
Division of Pediatric Plastic Surgery, The Children's Memorial Hospital, Chicago, IL, USA.
Seitz
Iris A
IA
Song
David H
DH