Scaglioni Mario F, Eder Maximilian, Giovanoli Pietro
Department of Plastic and Hand Surgery, University Hospital Zurich, Zurich, Switzerland.
Breast Centre Zurich, Zurich, Switzerland.
Microsurgery. 2018 Jul;38(5):558-562. doi: 10.1002/micr.30187. Epub 2017 May 12.
The posteromedial thigh (PMT) flap has been described for breast reconstruction in vertical fashion (vPMT). However, it might not incorporate enough soft tissue for reconstruction of a medium size breast. Here, we present a case utilizing the free inverted-L posteromedial thigh (L-PMT) flap for autologous reconstruction of the breast. A 65-year-old woman with a body max index (BMI) of 24.5 kg/m underwent nipple sparring mastectomy and received immediate unilateral breast reconstruction. The flap was raised based on the first medial perforator of the profunda femoris artery (PFA). The internal mammary artery and vein were dissected as recipient vessels. The flap size was 25 cm × 25 cm. The mastectomy specimen and weight of the flap was 260 g and 310 g, respectively. The flap survived completely after surgery. The donor site was primarily closed with minimal morbidities. Follow-up observations were conducted from 1 to 6 months. The patient was satisfied with the reconstruction. The free L-PMT flap may be suitable for breast reconstruction in women with moderate breast size. The inverted-L pattern of the PMT flap allows the surgeon to include a bigger quantity of flap soft tissue enabling a more anatomical shape of the breast and represents an alternative design that may be used for autologous breast reconstruction in selected patients.
股后内侧（PMT）皮瓣已被描述用于垂直式乳房重建（vPMT）。然而，它可能无法纳入足够的软组织来重建中等大小的乳房。在此，我们展示一例使用游离倒L形股后内侧（L-PMT）皮瓣进行乳房自体重建的病例。一名65岁女性，身体质量指数（BMI）为24.5kg/m²，接受了保留乳头的乳房切除术，并立即进行了单侧乳房重建。皮瓣基于股深动脉（PFA）的第一内侧穿支掀起。胸廓内动静脉被解剖作为受区血管。皮瓣大小为25cm×25cm。乳房切除标本和皮瓣重量分别为260g和310g。术后皮瓣完全存活。供区一期关闭，并发症极少。进行了1至6个月的随访观察。患者对重建效果满意。游离L-PMT皮瓣可能适用于中等乳房大小女性的乳房重建。PMT皮瓣的倒L形使外科医生能够纳入更多的皮瓣软组织，从而使乳房形状更符合解剖结构，是一种可供特定患者用于自体乳房重建的替代设计。
