Tawa P, Foirest C, Tankéré F, Ouar N, Brault N, Atlan M, Qassemyar Q
Service de chirurgie plastique, reconstructrice et esthétique - microchirurgie - régénération tissulaire, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France; Service de chirurgie plastique, reconstructrice et brûlés, hôpital Armand-Trousseau, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France.
Service d'oto-rhino-laryngologie, hôpital de la Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
Ann Chir Plast Esthet. 2019 Aug;64(4):368-373. doi: 10.1016/j.anplas.2019.01.001. Epub 2019 Mar 1.
The thoracodorsal artery perforator flap is increasingly used in head and neck reconstructions. One of its multiple advantages is the low donor site morbidity compared to the other free flaps usually used for this type of surgery, such as the radial forearm free flap and the anterolateral flap of the thigh. However, the current harvesting technique of the thoracodorsal artery free perforator flap needs a vertical incision rising high in the axillary hollow for the dissection of the pedicle, thus impeding optimal discretion of the donor site, especially for women. We describe an original technique to harvest a pure transversal skin paddle on its own perforator, leaving a horizontal scar thoroughly hidden in the bra and preserving the thoracodorsal pedicle. We detail the requirements for this new type of harvesting.
胸背动脉穿支皮瓣越来越多地用于头颈部重建。其众多优点之一是与通常用于此类手术的其他游离皮瓣（如桡侧前臂游离皮瓣和股前外侧皮瓣）相比，供区并发症发生率较低。然而，目前胸背动脉游离穿支皮瓣的切取技术需要在腋窝凹陷处高位做一垂直切口来解剖蒂部，从而影响了供区的最佳隐蔽性，尤其是对女性而言。我们描述了一种原始技术，即仅在其自身穿支上切取一个纯横向皮瓣，使一条水平瘢痕完全隐藏在胸罩内，并保留胸背蒂部。我们详细介绍了这种新型切取方法的要求。
