title: A thoracodorsal artery perforator chimeric free flap for prevention of microvascular pedicle compression in lower extremity reconstruction.
abstract: BACKGROUND
  Chimeric flaps are often used in reconstructive fields for multiple defects, different functional defects, and extensive defects. In this article, we present the results of the use of thoracodorsal artery perforator (TDAp) chimeric flaps including a latissimus dorsi (LD) or serratus anterior (SA) muscle to prevent pedicle compression for lower extremity reconstruction.
  
  
  METHODS
  Nineteen TDAp chimeric flaps were used to prevent pedicle compression. Seven were female and 12 male. Patients' age ranged from 32 to 73 years. After harvesting TDAp skin flap, LD or SA muscle could be harvested along with the thoracodorsal vessels. Skin flap was incorporated into the main defect and muscle cuffs were positioned along the vascular pedicle.
  
  
  RESULTS
  In 11 cases, there were two components, a skin flap and a muscle flap, and the other 8 were three components, a skin flap and two muscle flaps. The dimensions of the skin flaps ranged from 8 × 5 to 18 × 10 cm, and the muscle flaps ranged from 3 × 2 cm to 8 × 6 cm. The recipient vessel was anterior tibial artery or dorsalis pedis artery. All flap survived. Five cases suffered minor complications including donor site wound disruption, skin flap wound disruption, partial loss of the skin flap, and partial loss of the SA muscle flap. The mean follow-up was 13.9 months. All the patients were able to wear shoes without debulking procedures.
  
  
  CONCLUSIONS
  The TDAp chimeric flaps including LD or SA muscle flaps were useful for covering the vascular pedicle and relieved vascular compression during lower extremity reconstruction. © 2015 Wiley Periodicals, Inc. Microsurgery, 38:46-50, 2018..
authors.affiliation: Department of Plastic and Reconstructive Surgery, College of Medicine, Seoul National University, Seoul National University Hospital, Seoul, Korea.
authors.forename: Sang Wha
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Plastic and Reconstructive Surgery, College of Medicine, Seoul, Korea.
authors.forename: Dong Geun
authors.initials: DG
authors.lastname: Youn
authors.affiliation: Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Korea.
authors.forename: Jeong Tae
authors.initials: JT
authors.lastname: Kim
authors.affiliation: Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Korea.
authors.forename: Youn Hwan
authors.initials: YH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D001158:Arteries / Q000637:transplantation; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000098:blood supply* / Q000637:transplantation; D006085:Graft Survival; D006801:Humans; D007869:Leg Injuries / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D019651:Plastic Surgery Procedures / Q000379:methods*; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000209:etiology / Q000517:prevention & control*