Thoracodorsal artery perforator flap, a workhorse flap

Abstract

Objectives: TDAP is a workhorse flap as free and pedicled flap in complex soft tissue reconstructionBackground: Improvements in our knowledge of the vascular anatomy have enabled the design of a new type of fasciocutaneous flaps, which are based on perforating vessels only. Thus, donor site morbidity is markedly reduced.Methods: The authors describe their experience about the role of TDAP flap in reconstruction of different complex tissue defects. Representative cases are presented for illustration.Results: We conducted a study involving 24 patients who underwent TDAP flap reconstructions from January 2022 to January 2024. The patients aged 4 to 49 years. Flaps ranged in size from 12 cm × 6 cm to 26 cm × 15 cm. In 12 cases, two perforators were identified; in 9 cases, one perforator; and in 3 cases, three perforators. Free TDAP flaps were used in 17 cases, while pedicled flaps were used in 7 cases. The donor site was primarily closed in all cases without any movement restrictions. There was one case of partial flap loss, but no cases of total flap loss.Conclusions: TDAP flap provides a reliable and versatile option for plastic surgeons in reconstruction of complex soft tissue defects with limited donor site morbidity and excellent functional and esthetic results.