The Profunda Artery Perforator (PAP) Flap Experience for Breast Reconstruction*.

Background: The profunda artery perforator (PAP) flap was first introduced as a modality for breast reconstruction in 2010. Herein, we analyze the results of all PAP flaps performed by our group thus far to demonstrate that it is a reliable option for breast reconstruction. Methods: A retrospective review was completed of consecutive PAP flaps performed by the senior author from 2010-2014. Patient demographics, indications, operative techniques, flap specifics, complications and number of operations were recorded. Results: Ninety-six patients have undergone 164 PAP flaps for breast reconstruction since 2010. Reconstructions were performed following breast cancer management (59.5%), following prophylactic mastectomy for cancer risk reduction (35.7%) and for congenital breast deformity (4.8%). The average age of the patients was 48 years (24-64 years), with an average BMI of 22.5-kg/m2. Significant past medical history included smoking (18.8%), chemotherapy (38.8%), radiation therapy (18%) and previous abdominal surgery (60.4%). Average flap weight was 367.4-g, and average pedicle length was found to be 10.2-cm. Flap dimensions averaged 27.2-cm x 6.3-cm. The success rate of the PAP flap was >99%, with a 3% take-back rate and only one flap loss recorded (technical error, salvaged with DIEP flap). Complications included hematoma (1.9%), seroma (6%), fat necrosis (7%), and donor site infection (1.9%). Conclusions: The PAP flap is an excellent option for breast reconstruction. Advantages include a reliable blood supply, long pedicle, thick donor tissue and a favorable donor site. Currently, the PAP flap is second only to the DIEP flap in our armamentarium for breast reconstruction. (C)2016American Society of Plastic Surgeons

from #ENT via xlomafota13 on Inoreader http://ift.tt/29nSZqi
via IFTTT