Thoracodorsal Artery Perforator Flap, A Workhorse Flap

El Nahas, Mohamed Abdallah; Ghareeb, Fouad Mohamed; Abolhoda, Mohamed Salah

doi:10.21608/ejprs.2025.405241

Thoracodorsal Artery Perforator Flap, A Workhorse Flap

Document Type : Original Article

Authors

The Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Menoufia University

10.21608/ejprs.2025.405241

Abstract

Background: Improvements in our knowledge of vascular
anatomy have enabled the design of a new type of fascio-
cutaneous flaps, which are based on perforating vessels
only. Thus, donor site morbidity is markedly reduced.
Objective: Our study aimed to ease flap harvest,
shorten operation time, minimize donor site morbidity,
maximize esthetic outcome, decrease complication rates and
post-operative recovery time and therefore TDAP flap is considered
as a work horse flap.
Methods: The authors describe their experience about the
role of TDAP flap in reconstruction of different complex tissue
defects. Representative cases are presented for illustration.
Results: We conducted a study involving 24 patients who
underwent TDAP flap reconstructions from January 2022 to
April 2024. The patients aged 4 to 49 years. Flaps ranged in
size from 12cm × 6cm to 26cm × 15cm. In 12 cases, one perforator
was identified: In 9 cases, two perforators and in 3 cases,
three perforators. Free TDAP flaps were used in 17 cases,
while pedicled flaps were used in 7 cases. The donor site was
primarily closed in all cases without any movement restrictions.
There was one case of partial flap loss, but no cases of
total flap loss occurred.
Conclusions: TDAP flap provides a reliable and versatile
option for plastic surgeons in the reconstruction of complex soft
tissue defects with limited donor site morbidity and excellent
functional and esthetic results.

Keywords

Main Subjects

Flaps

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