The Versatility Of Profunda Femoris Artery Perforator Flap For Reconstruction
Ran Ito, MD, PhD1, Jung-Ju Huang, MD2, Chih-Wei Wu, MD2, Chia-Yu Lin, M.Sc.2, Ming-Huei Cheng, MD, MBA2.
1Kyoto University, Kyoto, Japan, 2Chang Gung Memorial Hospital, Taoyuan, Taiwan.
PURPOSE: The profunda feomris artery perforator (PAP) flap was recently introduced and gains popularity as an alternative method of autologous breast reconstruction with favorable outcomes. The purpose of this article is to demonstrate that PAP flap can be used reliably for reconstruction of any soft tissue defects as well as breast reconstruction.
METHODS: A total of 55 free PAP flaps and 16 pedicle PAP flaps were transferred in 63 patients. Each case was reviewed to verify a PAP flap was performed identifying defect location, flap size, flap design, and post-operative complications.
RESULTS: 7 flaps in 5 patients underwent breast reconstruction, 48 patients underwent head & neck reconstruction using free PAP flap. The flap survival rate was 100%, however, there were minor complications including wound poor healing (1/55, 1.8%), flap partial necrosis (3/55, 5.5%), and pedicle vessels problems including artery or venous thrombosis (3/55, 5.5%). A total of 16 pedicle PAP flaps were transferred in 10 patients for vulvar reconstruction. All flaps were transferred successfully, with a 100% flap survival rate. There were minor complications including urinary tract infection (1/10, 10%), poor wound healing (7/16, 43.8%), wound infection (3/16, 18.8%), hematoma (1/16, 6.3%).
CONCLUSIONS: The anatomy and number of perforators of PAP flap are reliable with adequate pedicle length. The donor site scar is well-hidden with minimal morbidities which makes this flap an excellent option for reconstruction of most soft tissue defects as well as breast reconstruction.
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