[Breast reconstruction with profunda artery perforator flap: A prospective study of 30 consecutive cases].

INTRODUCTION

Many flaps have been described in autologous breast reconstruction, the most common being the deep inferior epigastric perforator (DIEP) flap. This flap cannot be harvested in a certain range of patients. The profunda artery perforator (PAP) flap, based on perforators from profunda femoral artery, is therefore a good option.

OBJECTIVE

The goal was to highlight technical tips, particularities, and complications of our series of the 30 first PAP flaps for breast reconstruction in our department.

PATIENTS AND METHOD: We did a prospective study of all PAP flaps for breast reconstruction between November 2014 and October 2015. Thirty patients were included. We used 2 different types of skin design: classical or with vertical extension. The following parameters were recorded: pedicle length, flap weight, surgery duration, complications on donor or recipient site and type of recipient vessels.

RESULTS

Seventy-seven percent of the cases were delayed breast reconstruction, 23% were immediate. Twenty-five flaps were with classical skin design, and 5 with vertical extension. Mean flap weight was 301g (195-700g). Mean pedicle length was 9.88cm (8.2-12.5cm). Internal mammary vessels were the recipient vessels for 90% of the patients, versus 10% for circumflex scapular vessels. Mean surgery duration was 328min (195-610min). We had two total flap failures. The complications on the donor-site were 2 seroma, and 4 late healing scars. No lymphoedema occurred.

CONCLUSION

PAP flap is a good option when abdominal flap harvesting is not possible. The donor-site is well tolerated, with low morbidity. The indication is for patients with small to medium breast volume.