title: Anatomical basis of the extended TDAP flap: study of its territories of vascularization and its volume.
abstract: BACKGROUND
  The concept of extended thoracodorsal artery perforator (TDAP) flap was described in 2015 for breast reconstruction. Our anatomical study aims to identify the territories vascularised by the thoracodorsal artery perforator via the deep muscular fascial network. The second goal was to define the volume of the extended TDAP flap.
  
  
  METHODS
  Ten extended TDAP flaps were dissected on 5 fresh human cadavers. Around the classical skin paddle of a TDAP flap, the dissections were performed in a subfascial level, including the muscular fascia and the adipose tissue compartments to increase the volume of the flap. After injection of methylene blue in the thoracodorsal artery, we measured the length and width, the surface and the volume of the coloured flap.
  
  
  RESULTS
  The mean sizes of the extended TDAP flap were 24.9 cm × 20.1 cm. The mean surface of the total vascularization zone was 441 cm2. The mean volume of the vascularized flap was 193 ml.
  
  
  CONCLUSIONS
  The thoracodorsal artery perforator via the deep muscular fascial network allows us to harvest a flap of 25 cm × 20 cm with a mean surface of 441 cm² and a mean volume of 193 ml. The extended TDAP flap is a credible option in breast reconstruction.
authors.affiliation: Department of Plastic Reconstructive and Aesthetic Surgery, University Hospital of Picardie, Amiens Picardie University Hospital, rue Laennec, Salouel, 80054, Amiens Cedex, France. s.dast@hotmail.fr.
authors.forename: Sandy
authors.initials: S
authors.lastname: Dast
authors.affiliation: Department of Organogenesis and Anatomy, Université de Picardie Jules Verne, Amiens, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Havet
authors.affiliation: Department of Plastic and Craniofacial Surgery, University Hospital of Montpellier, Montpellier, France.
authors.forename: Lidia
authors.initials: L
authors.lastname: Dessena
authors.affiliation: Department of Plastic Reconstructive and Aesthetic Surgery, University Hospital of Picardie, Amiens Picardie University Hospital, rue Laennec, Salouel, 80054, Amiens Cedex, France.
authors.forename: Abeer
authors.initials: A
authors.lastname: Abdulshakoor
authors.affiliation: Department of Plastic Reconstructive and Aesthetic Surgery, University Hospital of Picardie, Amiens Picardie University Hospital, rue Laennec, Salouel, 80054, Amiens Cedex, France.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Alharbi
authors.affiliation: Department of Plastic Reconstructive and Aesthetic Surgery, University Hospital of Picardie, Amiens Picardie University Hospital, rue Laennec, Salouel, 80054, Amiens Cedex, France.
authors.forename: Richard
authors.initials: R
authors.lastname: Vaucher
authors.affiliation: Department of Plastic and Craniofacial Surgery, University Hospital of Montpellier, Montpellier, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Herlin
authors.affiliation: Department of Plastic Reconstructive and Aesthetic Surgery, University Hospital of Picardie, Amiens Picardie University Hospital, rue Laennec, Salouel, 80054, Amiens Cedex, France.
authors.forename: Raphael
authors.initials: R
authors.lastname: Sinna
mesh_terms: D002102:Cadaver; D004210:Dissection; D005205:Fascia; D006801:Humans; D016462:Mammaplasty; D018482:Muscle, Skeletal / Q000601:surgery; D061525:Perforator Flap / Q000098:blood supply*; D035441:Thoracic Wall
keywords: Breast reconstruction; Flap; Thoracodorsal artery perforator; Vascularisation; Volume