The use of thoracodorsal artery perforator flaps

The latissimus dorsi musculocutaneous flap is one of the most commonly used flaps in microsurgical reconstruction. However, donor site morbidity from harvesting the muscle cannot be ignored. Several authors have reported the incidence of spinal deformity among infants. The thoracodorsal artery perforator flap was first described by Angrigiani in 1995 as a "latissimus dorsi musculocutaneous flap without sacrifice of the muscle". This flap is based on a cutaneous perforator from the thoracodorsal vessels which pass underneath the latissimus dorsi muscle. We report our experience with the thoracodorsal artery perforator flap. Between February of 1997 and March of 2006, 10 clinical cases underwent reconstruction using the thoracodorsal artery flap. The main advantages of the thoracodorsal artery perforator flap are as follows : It has a longer vascular pedicle. Minimum donor site morbidity is expected. Donor site scar is inconspicuous. There is no need for secondary correction because the skin flap is relatively thin. The vascular territory is extremely wide. It provides well-vascularized tissue that controls infection. The successful treatment of chronic infection will depend on adequate debridement and obliteration of dead spaces with an effective flap. We conclude that the thoracodorsal artery perforator flap is useful for the repair of large defects with chronic infection.