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Profunda artery perforator flap

Maximilian Zaussinger, Ines E Tinhofer, Ulrike Hamscha, Stefan Meng, Wolfgang J Weninger, Michael S Pollhammer, Georg M Huemer, Manfred Schmidt
BACKGROUND: Perforator flaps of the upper thigh or buttock provide a valuable secondary choice in autologous breast reconstruction. The purpose of this study was to compare the vascular territories and supplying vessels of the transverse myocutaneous gracilis flap, the profunda artery perforator flap, and the fasciocutaneous infragluteal flap. METHODS: In total, 26 lower limbs from 13 fresh specimens were investigated. All flap pedicles were selectively injected with methylene blue, eosin red, or green ink...
February 2019: Plastic and Reconstructive Surgery
Pedro Ciudad, Tony Chieh-Ting Huang, Oscar J Manrique, Mouchammed Agko, Stamatis Sapountzis, Fabio Nicoli, M Diya Sabbagh, Luis Parra Pont, Steven L Moran, Hung-Chi Chen
BACKGROUND: The medial thigh is a well-hidden area. The two most common flaps from this area are the transverse upper gracilis (TUG) and profunda artery perforator (PAP) flaps. Herein, we explored the applications of combined TUGPAP flap to reconstruct large and complex defects in different regions. METHODS: Between November 2015 and May 2017, 28 patients who underwent reconstruction and extensive soft tissue coverage with the TUGPAP flap for the breasts, head and neck, and pelvi-perineal regions were included...
December 17, 2018: Microsurgery
Sumeet S Teotia, Min-Jeong Cho, Nicholas T Haddock
Background: Over the years, the choice of recipient vessels for free flap autologous breast reconstruction has shifted from the thoracodorsal to the internal mammary vessels due to ease of flap inset and predictability of anatomy. However, thoracodorsal vessels are still great recipient vessels, and can be useful, especially in the previously failed or staged autologous breast reconstruction. In this study, we present our experience using thoracodorsal or serratus vessels for profunda artery perforator flaps...
September 2018: Plastic and Reconstructive Surgery. Global Open
E Muller-Sloof, H E W de Laat, S L M Hummelink, J W B Peters, D J O Ulrich
AIM: Wound dehiscence is a serious postoperative complication associated both with high morbidity and mortality. It has a significant rate of occurrence in breast reconstruction surgeries with a deep internal epigastric perforator (DIEP) and with a profunda artery perforator (PAP) flap. Risk factors for wound dehiscence include smoking, diabetes mellitus, chronic obstructive pulmonary disease, and obesity. The aim of this pilot study was to assess whether postoperative treatment with closed incision negative pressure therapy (ciNPT) decreases the incidence of donor site wound dehiscence in breast reconstruction patients...
August 14, 2018: Journal of Tissue Viability
Mario F Scaglioni, Andrè A Barth, Yen-Chou Chen
INTRODUCTION: The primary closure of the vertical posteromedial thigh (vPMT) free flap donor site is very important to minimize donor site morbidity and maximize cosmetic appearance. However, sometimes due to the dimension of the defect, a vPMT flap is wider than the 8-10 cm requirement. The authors report their experience with the third perforator of the profunda femoris artery (PFA) during the vPMT free flap donor-site closure. PATIENTS AND METHODS: Between January 2016 and December 2017, 5 patients underwent reconstruction of lower extremity (2 pts...
October 2018: Microsurgery
Tadanobu Onishi, Takamasa Shimizu, Shohei Omokawa, Kanit Sananpanich, Akira Kido, Pasuk Mahakkanukrauh, Yasuhito Tanaka
There is lack of anatomical information regarding the cutaneous perforator of the popliteal artery and its connections with the descending branch of the inferior gluteal and profunda femoris arteries. The authors aimed to evaluate the anatomical basis of the popliteal artery perforator-based propeller flap from the posterior thigh region and to demonstrate their experience using this flap. Ten fresh cadaveric lower extremities were dissected following injection of a silicone compound into the femoral artery...
August 2018: Plastic and Reconstructive Surgery
Vincent Hunsinger, Martin Lhuaire, Kevin Haddad, Francesco-Saverio Wirz, Samah Abedalthaqafi, Déborah Obadia, Mohamed Derder, Alexandre Marchac, Marc David Benjoar, Mikael Hivelin, Laurent Lantieri
BACKGROUND:  The volume of the profunda femoris artery perforator (PAP) flap limits its indications to small- and medium-sized breast reconstructions after modified radical mastectomy for cancer. We report a modified PAP flap design, including not only a vertical extension that increases its volume but also the skin surface, which suits larger breasts requiring immediate or delayed breast reconstructions and compare the results with our horizontal skin paddle PAP flap experience. PATIENTS AND METHODS:  In our center between November 2014 and November 2016, 51 consecutive patients underwent a PAP flap breast reconstruction following breast cancer...
June 2, 2018: Journal of Reconstructive Microsurgery
Jordan D Frey, John T Stranix, Michael V Chiodo, Michael Alperovich, Christina Y Ahn, Robert J Allen, Mihye Choi, Nolan S Karp, Jamie P Levine
BACKGROUND: Free flap monitoring in autologous reconstruction after nipple-sparing mastectomy remains controversial. The authors therefore examined outcomes in nipple-sparing mastectomy with buried free flap reconstruction versus free flap reconstruction incorporating a monitoring skin paddle. METHODS: Autologous free flap reconstructions with nipple-sparing mastectomy performed from 2006 to 2015 were identified. Demographics and operative results were analyzed and compared between buried flaps and those with a skin paddle for monitoring...
May 2018: Plastic and Reconstructive Surgery
Allyson R Alfonso, James L Mayo, Vishal K Sharma, Robert J Allen, Ernest S Chiu
BACKGROUND: Plantar foot reconstruction requires special consideration of both form and function. There are several fasciocutaneous flap options, each with indications and reservations. CASE STUDY: This case presents a new application of the vertical profunda artery perforator flap for definitive closure of a neuropathic foot ulcer in a young woman with spina bifida. The postoperative course was uneventful, and the flap survived completely. The surgical and donor sites were without wound recurrence at 5-month follow-up...
February 2018: Advances in Skin & Wound Care
J-M Fichelle
Long-term iliofemoral complications induced by radiation include vascular (arterial and venous) lesions, nervous lesions and soft tissue loss that can be cutaneous and subcutaneous and potentially lead to radionecrosis with vessel exposure. We present five cases of groin radionecrosis. There were three men and two women (age 30-73 years). Radiotherapy had been delivered 15 years earlier in three cases, and 2 years earlier in two cases. Symptoms were intermittent claudication (n=1), critical ischemia (n=1), and septic hemorrhage (n=1)...
December 2017: Journal de Médecine Vasculaire
Andreas Kehrer, Ming-Yi Hsu, Yu-Ting Chen, Neil S Sachanandani, Chung-Kan Tsao
INTRODUCTION: Optimal design of PAP flaps requires precise perforator mapping. In a systematic review, Doppler ultrasonography demonstrated the highest sensitivity and positive predictive value (PPV). We present a prospective study of PAP flap design comparing PDU, handheld Doppler (HHD), and clinical findings. METHODS: From May to July 2016, 12 head and neck cancer patients receiving PAP flaps were examined with PDU and HHD. We used PDU to evaluate number, course, emergence point, peak systolic velocity (PSV), and arterial diameter of perforators...
November 4, 2017: Microsurgery
Mario F Scaglioni, Alberto Franchi, Pietro Giovanoli
INTRODUCTION: The posteromedial thigh (PMT) perforator flap is a valuable reconstructive option. In its pedicled form, the experience is currently limited to a few case reports. The purpose of this article is to describe various clinical applications of the pedicled posteromedial thigh (pPMT) flap for reconstruction of loco-regional soft tissue defects. PATIENTS AND METHODS: From 2014 to 2016, 15 patients underwent reconstruction with 15 pPMT flaps. The locations of the defects included the inguinal region (4 cases), the perineal and genital region (3 cases), the proximal and distal medial thigh (3 and 2 cases, respectively), and the popliteal fossa (3 cases)...
February 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Joseph H Dayan, Robert J Allen
Thigh-based flaps are typically a secondary option for breast reconstruction because of concerns regarding limited tissue volume and donor-site morbidity. In recent years, there have been a number of new techniques and insights that have resulted in greater flexibility and improved outcomes. This article reviews lessons learned from a large collective experience using the following 4 flaps: transverse upper gracilis also known as transverse myocutaneous gracilis, diagonal upper gracilis, profunda artery perforator, and lateral thigh perforator flaps...
November 2017: Plastic and Reconstructive Surgery
Anouk J M Cornelissen, Jop Beugels, Arno Lataster, Esther M Heuts, Shai M Rozen, Aldona J Spiegel, René R W J van der Hulst, Stefania M H Tuinder
INTRODUCTION: Autologous breast reconstruction has become the standard care for breast cancer patients. Although excellent cosmetic results can be achieved, most reconstructed breasts fail to regain normal sensation. Nerve coaptation of the flap has been suggested to improve sensation; the effect of the donor flap native sensory threshold on the degree of sensory restoration is yet to be determined. The aim of this study is to evaluate the differences in sensation between various potential donor site regions in comparison to the sensation of the healthy breast...
March 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
S S Jing, B Winter-Roach, D Kosutic
No abstract text is available yet for this article.
April 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Alberto Franchi, Mario F Scaglioni
No abstract text is available yet for this article.
December 2017: Plastic and Reconstructive Surgery
Nicholas T Haddock, Andrew Gassman, Min-Jeong Cho, Sumeet S Teotia
BACKGROUND: Free and local flaps based on the profunda artery perforators were first used for reconstruction of pressure sores, burn contractures, and extremity wounds. Recently, a revised profunda artery perforator flap was introduced for breast reconstruction. However, despite increasing reports of the use of the flap, it remains a rarely used option. The authors present their early experience with the first 101 profunda artery perforator flaps used for breast reconstruction at their institution...
August 2017: Plastic and Reconstructive Surgery
P Fosseprez, A Gerdom, M Servaes, C Deconinck, G Pirson, A Berners
BACKGROUND: In recent years, the DIEP-flap has become the standard for autologous breast reconstruction. However, when abdominal donor site is unavailable, secondary options are numerous. This report documents our experience with PAP-flap breast reconstruction. METHOD: We carried out a retrospective study of patients who underwent reconstructive breast surgery by PAP-flaps in our institution since 2014. RESULTS: Seventeen PAP-flaps were carried out in 15 patients, two of which received consecutive reconstruction of each breast at distinct intervals...
December 2017: Annales de Chirurgie Plastique et Esthétique
Pieter Hupkens, Pèdrou B Westland, Dietmar J O Ulrich
No abstract text is available yet for this article.
July 2017: Annals of Plastic Surgery
Shivprasad Date, Pedro Ciudad, Michele Maruccia, Hung Chi Chen
No abstract text is available yet for this article.
July 2017: Annals of Plastic Surgery
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