title: Versatility of the thoracoacromial artery perforator flap in head and neck reconstruction.
abstract: BACKGROUND
  The thoracoacromial artery perforator (TAAP) flap used in its pedicle or in the free microvascular variant is an emerging flap for use as a reconstructive option for the head and neck region.
  
  
  METHODS
  Between 2006 and 2013, 17 patients with a mean age of 34 years (range, 17-59 years) underwent a TAAP flap procedure for reconstruction of postoncologic and posttraumatic head and neck defects.
  
  
  RESULTS
  The pedicle TAAP flap was used to reconstruct neck (n = 5) and hypopharyngeal defects (n = 5); the free TAAP flap was used to resurface lower hemiface (n = 4), tongue (n = 1), and intraoral (n = 2) defects. The flap size ranged from 4.5 × 7 cm to 12 × 17 cm, with a mean thickness of 0.5 cm. The pectoralis major muscle was preserved in all of the cases. All of the patients healed uneventfully. The donor site was closed directly in four cases; a skin graft was used in four patients, and the donor site was covered by a local flap in one case.
  
  
  CONCLUSIONS
  Our experience proved the consistent feasibility of the successful use of the TAAP flap for head and neck reconstructions resulting in adequate color matching, texture, and pliability in combination with limited anterior chest wall donor site morbidity. Its hairless nature ensures that this flap is a suitable primary option for inner lining reconstruction of oropharyngeal defects.
authors.affiliation: Division of Head and Neck Surgery, Department of Surgery, Hunan Provincial Tumor Hospital, XiangYa Medical School of Central South University, Changsha, Hunan, China.
authors.forename: Zan
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Plastic Surgery, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Cui
authors.affiliation: Division of Head and Neck Surgery, Department of Surgery, Hunan Provincial Tumor Hospital, XiangYa Medical School of Central South University, Changsha, Hunan, China.
authors.forename: Yi Xin
authors.initials: YX
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: L Scott
authors.initials: LS
authors.lastname: Levin
authors.affiliation: Division of Head and Neck Surgery, Department of Surgery, Hunan Provincial Tumor Hospital, XiangYa Medical School of Central South University, Changsha, Hunan, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Maxillofacial Surgery Unit, Hospital of Florence, Florence, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Spinelli
authors.affiliation: Plastic Reconstructive and Aesthetic Surgery Unit, Villa Salaria Clinic, Rome, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Lazzeri
authors.affiliation: Plastic and Reconstructive Surgery Unit, Campus Bio-Medico University, Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Persichetti
mesh_terms: D000293:Adolescent; D000328:Adult; D001158:Arteries / Q000601:surgery*; D003286:Contracture / Q000209:etiology / Q000601:surgery*; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000098:blood supply* / Q000601:surgery; D061525:Perforator Flap / Q000098:blood supply*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013909:Thorax / Q000098:blood supply*; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000601:surgery*