title: [Extension of the thoracodorsal artery perforator flap's pedicle: Anatomical study].
abstract: OBJECTIVE
  In recent years, the indications of latissimus dorsi myocutaneous flap decreased in favor of its version preserving muscle: the thoracodorsal artery perforator flap (TDAP). The intramuscular dissection reduce donor site morbidity but also allows an extension of the pedicle compared to conventional latissimus dorsi flap pedicle. The purpose of this study was to quantify objectively elongation of the pedicle when the perforator is dissected through the muscle.
  
  
  METHODS
  Sixteen TDAP flap were dissected in 9 cadavers. The pedicle was divided into 4 distinct parts: (1) hypodermis, (2) subcutaneous fat, (3) intramuscular, (4) conventional pedicle.
  
  
  RESULTS
  The length of the pedicle is significantly increased when the pedicle is dissected through the muscle. This extends the theoretical length from 5.25cm up to 9.19cm if the dissection is extended to the deep fat. Indeed, this results in a potentially exploitable TDAP pedicle length of 20.66cm.
  
  
  CONCLUSIONS
  The dissection of the perforator allows an extension of the pedicle of about 5 or 9cm if we continue the dissection in the subcutaneous fat. A long pedicle may be interesting in lower limb reconstructive surgery and facial reconstruction where microsurgery is not feasible.
authors.affiliation: Service de chirurgie plastique, reconstructive et esthétique, CHU Amiens Picardie, Salouel, 80054 Amiens cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Lenglet
authors.affiliation: Service de chirurgie plastique, reconstructive et esthétique, CHU Amiens Picardie, Salouel, 80054 Amiens cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Dast
authors.affiliation: Service de chirurgie plastique et craniofaciale, CHU de Montpellier, 34090 Montpellier, France.
authors.forename: L
authors.initials: L
authors.lastname: Dessena
authors.affiliation: Service de chirurgie plastique et craniofaciale, CHU de Montpellier, 34090 Montpellier, France.
authors.forename: C
authors.initials: C
authors.lastname: Herlin
authors.affiliation: Service de chirurgie plastique, reconstructive et esthétique, CHU de Toulouse, 31059 Toulouse, France.
authors.forename: B
authors.initials: B
authors.lastname: Chaput
authors.affiliation: Laboratoire d'anatomie, faculté d'Amiens, 3, rue des Louvels, 80036 Amiens, France.
authors.forename: E
authors.initials: E
authors.lastname: Havet
authors.affiliation: Service de chirurgie plastique, reconstructive et esthétique, CHU Amiens Picardie, Salouel, 80054 Amiens cedex, France; Laboratoire d'anatomie, faculté d'Amiens, 3, rue des Louvels, 80036 Amiens, France. Electronic address: raphaelsinna@gmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Sinna
mesh_terms: D000368:Aged; D002102:Cadaver; D005260:Female; D006801:Humans; D008297:Male; D061525:Perforator Flap / Q000098:blood supply*; D013895:Thoracic Arteries / Q000033:anatomy & histology* / Q000637:transplantation
keywords: Dissection intramusculaire; Intramuscular dissection; Lambeau perforant; Latissimus dorsi; Perforator flap; Pédicule thoracodorsal; Reconstruction; Thoracodorsal pedicle