title: Internal mammary artery perforator flap for reconstruction of the chest wall.
abstract: We used internal mammary artery perforator (IMAP) flaps from the opposite side for reconstruction of small-to-medium-sized defects in the chest wall. The IMAP flaps were used in two patients who had unhealed, localised ulcers of the chest wall with exposure of the ribs after radical mastectomy. The lesion was excised widely, and the flap, based on a perforator vessel in the second or third intercostal space of the opposite chest wall, was raised. The flap was rotated from 90° to 180° along the vascular axis to the chest wall defect. The donor site was closed primarily. Both flaps showed stable postoperative circulation and survived completely. Defects of the chest wall could be covered with healthy, well-vascularised tissue on one perforator without deep infection. The IMAP flap is a reliable and less invasive option to be considered for medial, localised, reconstruction of the chest wall.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University Yachiyo Medical Center, Chiba. m-take@tymc.twmu.ac.jp
authors.forename: Masaki
authors.initials: M
authors.lastname: Takeuchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sakurai
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008323:Mammary Arteries / Q000601:surgery / Q000637:transplantation*; D015409:Mastectomy, Radical / Q000009:adverse effects / Q000379:methods; D008875:Middle Aged; D061646:Operative Time; D061525:Perforator Flap / Q000098:blood supply*; D019651:Plastic Surgery Procedures / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D012883:Skin Ulcer / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D013529:Surgical Wound Dehiscence / Q000175:diagnosis / Q000601:surgery; D035441:Thoracic Wall / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology