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Profunda artery perforator flap provides safe alternative for breast reconstruction
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Breast reconstruction using the profundal artery perforator flap has high success rates and low complication rates, according to study results published in Plastic and Reconstructive Surgery.
“Although the [deep inferior epigastric artery perforator (DIEP)] flap is our first choice, some patients are not ideal candidates because of inadequate donor tissue volume, prior abdominal surgery or dislike for the abdominal donor-site scar,” the researchers wrote.
Ninety-six patients with underwent breast reconstruction using profundal artery perforator flaps with the senior author, Robert J. Allen, MD, as primary or assisting surgeon, between 2010 and 2014.
Mean patient age was 48 years (range, 24-64) and average patient BMI was 22.5 kg/m2. The reasons for reconstruction included: congenital breast deformity (4.8%), primary reconstruction after prophylactic mastectomy (35.7%) and postmastectomy reconstruction for breast cancer (59.5%).
A total of 164 flaps were identified. The average flap dimensions were 27.2 × 6.3 cm (range, 18-30 cm × 6-7 cm), with an average vascular pedicle length of 10.2 cm (range 8-13 cm), average artery diameter of 2.2 cm and average vein diameter of 2.6 cm. The average flap weight was 367.4 g (range 225-739 g), which compared closely to the average weight of mastectomy (364 g).
The success rate in this study was greater than 99% with a 3% take-back rate. There was one flap loss due to a technical error in perforator isolation, though this was repaired with a DIEP flap. Complications were limited to hematoma (1.9%), seroma (6%), fat necrosis (7%) and donor-site wound dehiscence (3.6%). – by Talitha Bennett
Disclosure: The researchers report no relevant financial disclosures.
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