Thoracodorsal Artery Perforator Flap for
Reconstruction
Kamran Khoobehi, MD,
Robert Allen, MD, and
Walton J. Montegut, MD.
Department of Plastic Surgery, Louisiana State University
Medical Center, New Orleans.
The perforator flaps for breast reconstruction have been
used at Louisiana State University Medical Center since 1992.
The most common flaps used are those taken from the abdomen
or buttocks based on the deep inferior epigastric perforators
or the gluteal artery perforators, respectively. Perforator
flaps have also been taken from the lateral thigh or saddlebag
area to be used for breast reconstruction. The perforator
flaps used as free flaps have been shown to be an attractive
alternative to musculocutaneous flaps in that they afford
complete muscle sparing and should lessen any complications
previously noted to be caused by the harvesting of muscle
(de, abdominal wall hernia, etc).
We have used perforator flaps based on the thoracodorsal
artery perforators. This allowed the harvesting of a large
paddle of skin and fat from the back without sacrifice of
the latissimus dorsi muscle. Research methods included cadaver
dissections and Doppler blood flow studies of the thoracodorsal
artery. We have had success in five clinical cases using T-DAP
flap for breast reconstruction, chest wall, and axillary and
distal wound coverage. We had one failure due to poor venous
outflow.
Southern Medical Journal Volume 89,
No. 10, October 1996
