title: Propeller thoracodorsal artery perforator flap for breast reconstruction.
abstract: BACKGROUND
  The thoracodorsal artery perforator (TDAP) flap has been described for breast reconstruction. This flap requires intramuscular dissection of the pedicle. A modification of the conventional TDAP surgical technique for breast reconstruction is described, utilizing instead a propeller TDAP flap. The authors present their clinical experience with the propeller TDAP flap in breast reconstruction alone or in combination with expanders or permanent implants.
  
  
  METHODS
  From January 2009 to February 2013, sixteen patients had breast reconstruction utilizing a propeller TDAP flap. Retrospective analysis of patient characteristics, clinical indications, procedure and outcomes were performed. The follow-up period ranged from 4 to 48 months.
  
  
  RESULTS
  Sixteen patients had breast reconstruction using a TDAP flap with or without simultaneous insertion of an expander or implant. All flaps survived, while two cases required minimal resection due to distal flap necrosis, healing by second intention. There were not donor-site seromas, while minimal wound dehiscence was detected in two cases.
  
  
  CONCLUSIONS
  The propeller TDAP flap appears to be safe and effective for breast reconstruction, resulting in minimal donor site morbidity. The use of this propeller flap emerges as a true alternative to the traditional TDAP flap.
authors.affiliation: Instituto Oncologico Henry Moore, Buenos Aires, Argentina.
authors.forename: Claudio
authors.initials: C
authors.lastname: Angrigiani
authors.affiliation: Instituto Oncologico Henry Moore, Buenos Aires, Argentina.
authors.forename: Alberto
authors.initials: A
authors.lastname: Rancati
authors.affiliation: Instituto Oncologico Henry Moore, Buenos Aires, Argentina.
authors.forename: Ezequiel
authors.initials: E
authors.lastname: Escudero
authors.affiliation: Instituto Oncologico Henry Moore, Buenos Aires, Argentina.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Artero
authors.affiliation: Instituto Oncologico Henry Moore, Buenos Aires, Argentina.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Gercovich
authors.affiliation: Instituto Oncologico Henry Moore, Buenos Aires, Argentina.
authors.forename: Ernesto Gil
authors.initials: EG
authors.lastname: Deza
keywords: Thoracodorsal artery perforator (TDAP); breast reconstruction; propeller flap