title: Thoracodorsal artery perforator flap: Indeed a versatile flap.
abstract: BACKGROUND
  The thoracodorsal artery perforator (TDAP) flap has emerged as one of the ideal perforator flaps. We, hereby, describe its versatility in indications (free/pedicled), methods of harvest (patient position and paddle orientation) and perforator consistency.
  
  
  METHODS
  We have performed a total of six TDAP flaps-five free and one pedicled, over a period of 1-year from March 2014 to February 2015 at a single centre. Our indications have been: Reconstruction of oral cavity, breast and upper and lower extremities.
  
  
  RESULTS
  We had neither any failures nor any re-explorations. The average perforator length is about 6 cm and the pedicle length can be extended to 12-14 cm by including the thoracodorsal artery. There is inconsistency in perforator position; however, the presence of a perforator is certain. It can be harvested in lateral, prone or supine position, thus, does not require any position change allowing a two-team approach to reconstruction. The paddle can be oriented vertically or horizontally, both healing with scars in inconspicuous locations. Apart from providing a good colour match for extremities, this flap can be thinned primarily.
  
  
  CONCLUSIONS
  The versatility of TDAP has several advantages that make it a workhorse flap for most reconstructions requiring soft tissue cover. Further, the ease of harvest makes it a good perforator flap for beginners. Its use in chimerism with the underlying latissimus dorsi muscle provides reconstruction for coverage and volume replacement.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India.
authors.forename: Leena
authors.initials: L
authors.lastname: Jain
authors.affiliation: Department of Plastic and Reconstructive Surgery, Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India.
authors.forename: Samir M
authors.initials: SM
authors.lastname: Kumta
authors.affiliation: Department of Plastic and Reconstructive Surgery, Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India.
authors.forename: Shrirang K
authors.initials: SK
authors.lastname: Purohit
authors.affiliation: Department of Plastic and Reconstructive Surgery, Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India.
authors.forename: Rashmi
authors.initials: R
authors.lastname: Raut
keywords: Ideal perforator flap; chimerism; septocutaneous perforator; versatile