title: The Versatile Extended Thoracodorsal Artery Perforator Flap for Breast Reconstruction.
abstract: BACKGROUND
  The thoracodorsal artery perforator (TAP) flap is a versatile tool that can be used to reconstruct the breast. The authors use preoperative perforator mapping using color Doppler ultrasonography and present a safe, efficient harvesting technique to demonstrate reliable use of the TAP flap in reconstructive surgery.
  
  
  METHODS
  A multicenter, retrospective review was performed on all patients undergoing TAP flap reconstruction from August 2011 to November 2014. Data were collected from patient records as well as outpatient interviews.
  
  
  RESULTS
  A total of 106 TAP flaps were performed in 97 patients. The flaps were raised with either 1 perforator (42/106), 2 perforators (55/106), or three perforators (9/106), and turned as a propeller in 99 of 106 (93%) flaps or buried as a turnover in 7 of 106 (7%) of flaps. The mean operative time was 200 minutes (range, 60-485). Major complications occurred in 10 of 106 (10%) cases and included hematoma (1/108), venous congestion (2/108), and partial flap necrosis (7/108). The reconstructive goal was achieved in 103 of 106 (97%) flaps.
  
  
  CONCLUSIONS
  The TAP flap is a pedicled, fasciocutaneous flap that can be used for total breast reconstruction as well as breast conserving surgery. This large, multicenter series describes our techniques of preoperative perforator mapping and a fast, reliable harvest. Reconstructive goals are accomplished in the great majority of patients.
authors.affiliation: From the *Division of Plastic Surgery, Mount Sinai Medical System, New York, NY; †Department of Plastic Surgery, Vejle Hospital/Odense University Hospital, Denmark; ‡Department of Plastic Surgery, Telemark Hospital, Skien, Norway; §Department of Plastic Surgery, Herlev Hospital; and ∥Department of Plastic Surgery, Odense University Hospital, Denmark.
authors.forename: Jordan
authors.initials: J
authors.lastname: Jacobs
authors.forename: Mikkel
authors.initials: M
authors.lastname: Børsen-Koch
authors.forename: Gudjon Leifur
authors.initials: GL
authors.lastname: Gunnarsson
authors.forename: Tina
authors.initials: T
authors.lastname: Tos
authors.forename: Elsebeth
authors.initials: E
authors.lastname: Siim
authors.forename: Ann
authors.initials: A
authors.lastname: Udesen
authors.forename: Lisbet Rosenkrantz
authors.initials: LR
authors.lastname: Hölmich
authors.forename: Andrew
authors.initials: A
authors.lastname: Salzberg
authors.forename: Jørn Bo
authors.initials: JB
authors.lastname: Thomsen
mesh_terms: D000328:Adult; D000368:Aged; D001158:Arteries / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D061525:Perforator Flap / Q000098:blood supply* / Q000601:surgery; D012189:Retrospective Studies; D018615:Ultrasonography, Doppler, Color