title: Clinical application of the thoracodorsal artery perforator flaps.
abstract: BACKGROUND
  Thoracodorsal artery perforator (TAP) flaps without latissimus dorsi muscle - have been used for reconstruction of the extremities, head and neck as free style flaps, and as pedicled flaps for reconstruction of the chest wall and axillary wounds. This retrospective study aimed to analyse the clinical applications and relevant anatomic findings of TAP flaps.
  
  
  METHODS
  From April 2007 to August 2011, 67 free or pedicled TAP flaps were transferred in 67 patients for reconstruction of wounds of the extremities, chest wall and axilla. Eight were used as free flaps for reconstruction of extremities, and 59 used as pedicled flaps for reconstruction of axillary or chest wounds. Patient ages ranged from 7 to 55 years (26.04±12.83). Perforator arteries were detected and identified with a hand-held Doppler. The size of flaps ranged from 6 by 9 to 14 by 18 cm ((8.66±2.05) by (12.62±2.03)). Flaps were designed with the perforator artery included, with all flaps based on one or two perforator arteries.
  
  
  RESULTS
  All of the flaps survived. There were no problems with vascular spasm or occlusion. Significant venous congestion was not observed in any of the cases. Two cases developed minor wound dehiscence but healed with conservative therapy. None of the donor sites developed seromas.
  
  
  CONCLUSIONS
  The thoracodorsal artery flap without associated latissimus dorsi muscle can provide a thin, large and reliable flap with robust blood supply. The TAP flap can significantly reduce donor site morbidity.
authors.affiliation: Department of Plastic Surgery and Aesthetic Surgery and Burns, Second XiangYa Hospital, Xiangya Medical School, Central South University, Changsha, Hunan 410011, China.
authors.forename: Li-chang
authors.initials: LC
authors.lastname: Yang
authors.forename: Xian-cheng
authors.initials: XC
authors.lastname: Wang
authors.forename: Michael L
authors.initials: ML
authors.lastname: Bentz
authors.forename: Bai-rong
authors.initials: BR
authors.lastname: Fang
authors.forename: Xiang
authors.initials: X
authors.lastname: Xiong
authors.forename: Xiao-fang
authors.initials: XF
authors.lastname: Li
authors.forename: Qin
authors.initials: Q
authors.lastname: Lu
authors.forename: Qian
authors.initials: Q
authors.lastname: Wu
authors.forename: Rui-feng
authors.initials: RF
authors.lastname: Wang
authors.forename: Wei
authors.initials: W
authors.lastname: Feng
authors.forename: Ji-yong
authors.initials: JY
authors.lastname: He
authors.forename: Yu-ying
authors.initials: YY
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D001365:Axilla / Q000601:surgery; D002648:Child; D015331:Cohort Studies; D005121:Extremities / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D061525:Perforator Flap / Q000098:blood supply*; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000379:methods*; D012039:Regional Blood Flow / Q000502:physiology; D012189:Retrospective Studies; D018570:Risk Assessment; D013524:Surgical Flaps / Q000098:blood supply; D013895:Thoracic Arteries / Q000601:surgery / Q000637:transplantation*; D035441:Thoracic Wall / Q000601:surgery; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*; D014947:Wounds and Injuries / Q000601:surgery; D055815:Young Adult