Versatility of thoracidorsal artery perforator flap in reconstruction of axilla

Abstract

Objective: This study examines the merits, drawbacks, and possible complications associated with using the thoracodorsal artery perforator (TDAP) flap for axillary reconstruction. Background: The TDAP flap offers a pedicled approach for axillary reconstruction, characterized by consistent flap thickness, minimal donor site complications, and dependable vascular anatomy with a lengthy pedicle. Methods: A prospective cohort study was conducted at Menoufia University Hospital's surgery department from January 2022 to January 2023, involving 20 patients needing axillary reconstruction due to defects. Inclusion criteria included patients aged 18 to 60 years with axillary contractures, suitable for anesthesia, and lacking significant underlying health issues. Results: Evaluation using the Constant-Murley score demonstrated a substantial enhancement in shoulder function after the procedure, approaching normal levels, particularly in terms of pain, daily activities, and range of motion. Preoperatively, abduction strength was largely unaffected, as the condition doesn't directly impact shoulder muscles or the joint itself. The average preoperative Dermatology Life Quality Index (DLQI) score was 12.3 (range: 9–15), decreasing to 2.99 (range: 2–7) one year postoperative. Conclusion: Axillary reconstruction presents intricate challenges, necessitating careful selection of specific reconstructive techniques. Thoracodorsal artery perforator flaps have emerged as a significant option for axillary reconstruction, either as standalone or combined with other methods.