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Vascular Variations and Approaches of PAP Flap

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Oncoplastic Flap Surgery
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Abstract

The posteromedial femoral perforator flap is regarded as a reliable choice for reconstructing defects in various parts of the body [1]. By understanding the anatomical study of the perforating branch of the profunda femoral artery, the vascular area of the perforating branch of the profunda femoral artery includes the whole medial and posterior thigh area [2]. After obtaining the vertically designed medial femoral perforator flap, the laser-assisted indocyanine green angiography system further confirmed the size of the vascular body area of the perforator of the profunda femoral artery.

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References

  1. Mayo JL, Canizares O, Torabi R, Allen RJ, St HH. Expanding the applications of the profunda artery perforator flap. Plast Reconstr Surg. 2016;137(2):663–9.

    Article  CAS  PubMed  Google Scholar 

  2. Ahmadzadeh R, Bergeron L, Tang M, Geddes CR, Morris SF. The posterior thigh perforator flap or profunda femoris artery perforator flap. Plast Reconstr Surg. 2007;119(1):194–200; discussion 201–2.

    Article  CAS  PubMed  Google Scholar 

  3. Hurwitz ZM, Montilla R, Dunn RM, Patel NV, Akyurek M. Adductor magnus perforator flap revisited: an anatomical review and clinical applications. Ann Plast Surg. 2011;66(5):438–43.

    Article  CAS  PubMed  Google Scholar 

  4. Saad A, Sadeghi A, Allen RJ. The anatomic basis of the profunda femoris artery perforator flap: a new option for autologous breast reconstruction—a cadaveric and computer tomography angiogram study. J Reconstr Microsurg. 2012;28(6):381–6.

    PubMed  Google Scholar 

  5. DeLong MR, Hughes DB, Bond JE, Thomas SM, Boll DT, Zenn MR. A detailed evaluation of the anatomical variations of the profunda artery perforator flap using computed tomographic angiograms. Plast Reconstr Surg. 2014;134(2):186e–92e.

    Article  CAS  PubMed  Google Scholar 

  6. Wu JC, Huang JJ, Tsao CK, Abdelrahman M, Kolios G, Cheng MH. Comparison of posteromedial thigh profunda artery perforator flap and anterolateral thigh perforator flap for head and neck reconstruction. Plast Reconstr Surg. 2016;137(1):257–66.

    Article  CAS  PubMed  Google Scholar 

  7. Scaglioni MF, Kuo YR, Yang JC, Chen YC. The posteromedial thigh flap for head and neck reconstruction: anatomical basis, surgical technique, and clinical applications. Plast Reconstr Surg. 2015;136(2):363–75.

    Article  CAS  PubMed  Google Scholar 

  8. Scaglioni MF, Chen YC, Yang JC. Posteromedial thigh (PMT) propeller flap for perineoscrotal reconstruction: a case report. Microsurgery. 2015;35(7):569–72.

    Article  PubMed  Google Scholar 

  9. Scaglioni MF, Enrique CJL, Kuo YR, Chen YC. Pedicled posteromedial thigh (PMT) flap: a new alternative for groin defect reconstruction. Microsurgery. 2017;37(4):339–43.

    Article  PubMed  Google Scholar 

  10. Wei FC, Jain V, Celik N, Chen HC, Chuang DC, Lin CH. Have we found an ideal soft-tissue flap? An experience with 672 anterolateral thigh flaps. Plast Reconstr Surg. 2002;109(7):2219–26; discussion 2227–30.

    Article  PubMed  Google Scholar 

  11. Song YG, Chen GZ, Song YL. The free thigh flap: a new free flap concept based on the septocutaneous artery. Br J Plast Surg. 1984;37(2):149–59.

    Article  CAS  PubMed  Google Scholar 

  12. Koshima I, Yamamoto H, Hosoda M, Moriguchi T, Orita Y, Nagayama H. Free combined composite flaps using the lateral circumflex femoral system for repair of massive defects of the head and neck regions: an introduction to the chimeric flap principle. Plast Reconstr Surg. 1993;92(3):411–20.

    Article  CAS  PubMed  Google Scholar 

  13. Lakhiani C, Lee MR, Saint-Cyr M. Vascular anatomy of the anterolateral thigh flap: a systematic review. Plast Reconstr Surg. 2012;130(6):1254–68.

    Article  CAS  PubMed  Google Scholar 

  14. Scaglioni MF, Chen YC, Lindenblatt N, Giovanoli P. The vertical posteromedial thigh (vPMT) flap for autologous breast reconstruction: a novel flap design. Microsurgery. 2017;37(5):371–6.

    Article  PubMed  Google Scholar 

  15. Allen RJ, Haddock NT, Ahn CY, Sadeghi A. Breast reconstruction with the profunda artery perforator flap. Plast Reconstr Surg. 2012;129(1):16e–23e.

    Article  PubMed  Google Scholar 

  16. Park JE, Alkureishi LW, Song DH. TUGs into VUGs and friendly BUGs: transforming the Gracilis territory into the best secondary breast reconstructive option. Plast Reconstr Surg. 2015;136(3):447–54.

    Article  CAS  PubMed  Google Scholar 

  17. Angrigiani C, Grilli D, Thorne CH. The adductor flap: a new method for transferring posterior and medial thigh skin. Plast Reconstr Surg. 2001;107(7):1725–31.

    Article  CAS  PubMed  Google Scholar 

  18. Haddock NT, Greaney P, Otterburn D, Levine S, Allen RJ. Predicting perforator location on preoperative imaging for the profunda artery perforator flap. Microsurgery. 2012;32(7):507–11.

    Article  PubMed  Google Scholar 

  19. Collins J, Ayeni O, Thoma A. A systematic review of anterolateral thigh flap donor site morbidity. Can J Plast Surg. 2012;20(1):17–23.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Ratanshi I, McInnes CW, Islur A. The proximal superficial femoral artery perforator flap: anatomic study and clinical cases. Microsurgery. 2017;37(6):581–8.

    Article  PubMed  Google Scholar 

  21. Satake T, Muto M, Ko S, Yasumura K, Ishikawa T, Maegawa J. Breast reconstruction using free posterior medial thigh perforator flaps: intraoperative anatomical study and clinical results. Plast Reconstr Surg. 2014;134(5):880–91.

    Article  CAS  PubMed  Google Scholar 

  22. Fansa H, Schirmer S, Warnecke IC, Cervelli A, Frerichs O. The transverse myocutaneous gracilis muscle flap: a fast and reliable method for breast reconstruction. Plast Reconstr Surg. 2008;122(5):1326–33.

    Article  CAS  PubMed  Google Scholar 

  23. Kappler UA, Constantinescu MA, Büchler U, Vögelin E. Anatomy of the proximal cutaneous perforator vessels of the gracilis muscle. Br J Plast Surg. 2005;58(4):445–8.

    Article  CAS  PubMed  Google Scholar 

  24. Schoeller T, Huemer GM, Wechselberger G. The transverse musculocutaneous gracilis flap for breast reconstruction: guidelines for flap and patient selection. Plast Reconstr Surg. 2008;122(1):29–38.

    Article  CAS  PubMed  Google Scholar 

  25. Hunter JE, Lardi AM, Dower DR, Farhadi J. Evolution from the TUG to PAP flap for breast reconstruction: comparison and refinements of technique. J Plast Reconstr Aesthet Surg. 2015;68(7):960–5.

    Article  CAS  PubMed  Google Scholar 

  26. Hupkens P, Van Loon B, Lauret GJ, et al. Anteromedial thigh flaps: an anatomical study to localize and classify anteromedial thigh perforators. Microsurgery. 2010;30(1):43–9.

    PubMed  Google Scholar 

  27. Hupkens P, Ozturk E, Wittens S, Hoevenaren IA, Kooloos JG, Ulrich DJ. Posterior thigh perforator flaps: an anatomical study to localize and classify posterior thigh perforators. Microsurgery. 2013;33(5):376–82.

    Article  PubMed  Google Scholar 

  28. Chuang DC. Free tissue transfer for the treatment of facial paralysis. Facial Plast Surg. 2008;24(2):194–203.

    Article  CAS  PubMed  Google Scholar 

  29. Hunter JE, Mackey SP, Boca R, Harris PA. Microvascular modifications to optimize the transverse upper gracilis flap for breast reconstruction. Plast Reconstr Surg. 2014;133(6):1315–25.

    Article  CAS  PubMed  Google Scholar 

  30. Hupkens P, Westland PB, Ulrich DJO. The combined transverse upper gracilis and profunda artery perforator flap for breast reconstruction-letter to the editor. Ann Plast Surg. 2017;79(1):124–5.

    Article  CAS  PubMed  Google Scholar 

  31. Lakhiani C, DeFazio MV, Han K, Falola R, Evans K. Donor-site morbidity following free tissue harvest from the thigh: a systematic review and pooled analysis of complications. J Reconstr Microsurg. 2016;32(5):342–57.

    Article  PubMed  Google Scholar 

  32. Dajiang Song, Zan Li, Xiao Zhou. Clinical application of free medial femoral chimeric perforator myocutaneous flap in the repair of postoperative defect of tongue cancer in the repair of defects after tongue cancer surgery. Chin J Otorhinolaryngol Head Neck Surg2017. 52(4): 278–282.

    CAS  Google Scholar 

  33. Song D, Li Z, Zhou X. Observation of curative effect of different forms of free profunda femoral artery pedicle chimeric perforator myocutaneous flap in the repair of defects after tongue cancer surgery. Chin J Reparat Reconstr Surg. 2017;31(06):696–701.

    Google Scholar 

  34. Song D, Li Z, Zhou X. Free profunda femoral artery pedicled gracilis chimeric musculocutaneous perforator flap for repair of defects after oral and buccal cancer surgery. Chin J Plast Surg. 2017;33(4):242–7.

    Google Scholar 

  35. Dajiang Song, Zan Li, Xiao Zhou. Application of profunda femoral artery perforator flap in breast reconstruction. Chin J Plast Surg 2017. (6): 412–416.

    Google Scholar 

  36. Ito R, Huang JJ, Wu JC, Lin MC, Cheng MH. The versatility of profunda femoral artery perforator flap for oncological reconstruction after cancer resection—clinical cases and review of literature. J Surg Oncol. 2016;114(2):193–201.

    Article  PubMed  Google Scholar 

  37. Kimura N, Satoh K, Hasumi T, Ostuka T. Clinical application of the free thin anterolateral thigh flap in 31 consecutive patients. Plast Reconstr Surg. 2001;108(5):1197–208; discussion 1209–10.

    Article  CAS  PubMed  Google Scholar 

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Song, D., Mitsunaga, N. (2023). Vascular Variations and Approaches of PAP Flap. In: Li, Z., Song, D. (eds) Oncoplastic Flap Surgery. Springer, Singapore. https://doi.org/10.1007/978-981-19-8926-1_20

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  • DOI: https://doi.org/10.1007/978-981-19-8926-1_20

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-19-8925-4

  • Online ISBN: 978-981-19-8926-1

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