Summary
The thoracodorsal (TD) vessels represent a complex vascular system that offers a variety
of pedicled and free flaps. Variations of the classical latissimus dorsi (LD) flap
have been developed to overcome its major drawbacks. The thoracodorsal artery perforator
(TDAP) flap described by Angrigiani represents one of these options. Other techniques
have been defined as “muscle-sparing” latissimus dorsi (MSLD) due to the preservation
of the LD muscle and the TD nerve, in whole or in part. Nevertheless, the term “muscle
sparing” has also been applied to the descending branch LD (DB-LD) flap which requires
the denervation of the LD muscle. According to our knowledge, there are no articles
in the literature reviewing and comparing the reconstructive options based on the
TD vessels. We performed a systematic search in PubMed, Web of Science, and Cochrane
databases to perform a literature review and meta-analysis about the reconstructive
options based on the TD vessels. The primary outcome of interest was the percentage
of flaps developing a specific early complication, i.e., hematoma of the donor site,
seroma of the donor site, partial flap loss, total flap loss, wound dehiscence, and
wound infection. Moreover, we analyzed the outcomes and complications of our cases,
comparing the MSLD flaps, the DB-LD flaps, and the TDAP flaps. According to both our
casuistry and the literature, the three techniques can be considered safe in terms
of early donor site complications. According to the literature, MSLD has been shown
to develop partial flap necrosis more frequently than the TDAP flap.
Keywords
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Article info
Publication history
Published online: June 28, 2022
Accepted:
June 21,
2022
Received:
March 29,
2022
Footnotes
The manuscripts, including figures, have not been previously or presented at any meeting.
Identification
Copyright
© 2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
