Department of Plastic Surgery and Aesthetic Surgery and Burns, Second XiangYa Hospital, Xiangya Medical School, Central South University, Changsha, Hunan 410011, China.
J Plast Reconstr Aesthet Surg. 2013 Feb;66(2):193-200. doi: 10.1016/j.bjps.2012.09.005. Epub 2012 Oct 25.
Thoracodorsal artery perforator (TAP) flaps without latissimus dorsi muscle - have been used for reconstruction of the extremities, head and neck as free style flaps, and as pedicled flaps for reconstruction of the chest wall and axillary wounds. This retrospective study aimed to analyse the clinical applications and relevant anatomic findings of TAP flaps.
From April 2007 to August 2011, 67 free or pedicled TAP flaps were transferred in 67 patients for reconstruction of wounds of the extremities, chest wall and axilla. Eight were used as free flaps for reconstruction of extremities, and 59 used as pedicled flaps for reconstruction of axillary or chest wounds. Patient ages ranged from 7 to 55 years (26.04±12.83). Perforator arteries were detected and identified with a hand-held Doppler. The size of flaps ranged from 6 by 9 to 14 by 18 cm ((8.66±2.05) by (12.62±2.03)). Flaps were designed with the perforator artery included, with all flaps based on one or two perforator arteries.
All of the flaps survived. There were no problems with vascular spasm or occlusion. Significant venous congestion was not observed in any of the cases. Two cases developed minor wound dehiscence but healed with conservative therapy. None of the donor sites developed seromas.
The thoracodorsal artery flap without associated latissimus dorsi muscle can provide a thin, large and reliable flap with robust blood supply. The TAP flap can significantly reduce donor site morbidity.
胸背动脉穿支（TAP）皮瓣不包含背阔肌 - 已被用于四肢、头颈部的游离皮瓣重建，以及胸壁和腋窝创面的带蒂皮瓣重建。本回顾性研究旨在分析 TAP 皮瓣的临床应用和相关解剖学发现。
2007 年 4 月至 2011 年 8 月，67 例患者接受了 67 例游离或带蒂 TAP 皮瓣转移手术，用于重建四肢、胸壁和腋窝创面。8 例用于重建四肢的游离皮瓣，59 例用于重建腋窝或胸壁创面的带蒂皮瓣。患者年龄 7-55 岁，平均 26.04±12.83 岁。使用手持式多普勒探测和识别穿支动脉。皮瓣大小 6×9 至 14×18cm，平均（8.66±2.05）×（12.62±2.03）cm。皮瓣设计包括穿支动脉，所有皮瓣均基于 1 或 2 条穿支动脉。
所有皮瓣均存活，无血管痉挛或阻塞问题。所有病例均无明显静脉淤血。有 2 例出现轻微伤口裂开，但经保守治疗愈合。供区无一例发生血清肿。
不包含背阔肌的胸背动脉皮瓣可以提供薄而宽大、血供可靠的皮瓣。TAP 皮瓣可显著降低供区并发症发生率。
