Double-Pedicled Profunda Femoral Artery Perforator Flap for Breast Reconstruction

Abstract

Since the first description of breast reconstruction with deep inferior epigastric artery perforator (DIEP) flap in 1992, the choice of autologous breast reconstruction has been developed [1]. DIEP flap has been the first choice for autologous breast reconstruction for a long time, and its advantages are obvious [2]. However, not all patients can be treated with DIEP flap [3, 4]. With the ongoing progress of microsurgical technology, the continuous development of tumor plastic surgery, and the emergence of novel flaps, it is important to analyze the results and compare them with the previous methods when new flaps are created. Different forms of various flaps have distinct indications and have their own subtle variations and characteristics. Hurwitz and Walton first described the profunda artery perforator flap in 1980 [5]. Later, Angrigiani et al. improved and applied it in clinic as a free flap for burn and bedsore reconstruction [6]. It was not until 2010 that the profunda femoral artery perforator flap was first reported for breast reconstruction. The landmark event was that the profunda artery perforator flap was first demonstrated for breast reconstruction at the International Conference of Perforator Flap in Mexico City in 2010 [7, 8]. The perforator flap of profunda femoral artery has been popularized, and there is an increasing number of reports in the literature. Since 2010, we have performed a series of profunda artery branch flap transplantation, and a lot of knowledge, details, and experience have been gained and understood about its advantages, disadvantages, and surgical techniques in the process of leveraging this flap [9–11]. In order to overcome the restrictions of small tissue volume and insufficient blood supply of the profunda artery perforator flap, we prepared external pressurized profunda femoral artery perforator flap with larger tissue volume and more reliable blood supply by dissecting double-vascular pedicle at the same time according to the anatomical basis of large number of perforator vessels in the posterior medial femoral region, and the clinical effects are satisfactory.