{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T06:25:43Z","timestamp":1782368743037,"version":"3.54.5"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,10,5]],"date-time":"2021-10-05T00:00:00Z","timestamp":1633392000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The profunda artery perforator (PAP) flap is a well\u2010known free flap for breast reconstruction. However, a reproducible perforator mapping system has yet to be developed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The PAP perforators were localized by CTA using a novel <jats:italic>X<\/jats:italic>\u2010<jats:italic>Y<\/jats:italic> axis system. Flap dimensions were based on the CTA images and localized PAP\u2010perforators. Perioperative findings and postoperative outcomes were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 70 lower limbs and 180 PAP perforators were evaluated. An average of 2.78\u2009\u00b1\u20091.22 and 2.22\u2009\u00b1\u20090.96 perforators were seen, in the right and left legs, respectively, and were divided in five clusters (PAP1\u2013PAP5) based on their location on the <jats:italic>Y<\/jats:italic>\u2010axis. The course of the perforators was noted as well as the average diameter at the origin. The overall average diameter was 1.99\u2009\u00b1\u20090.86\u2009mm. A banana\u2010shaped PAP\u2010flap was harvested in 10 patients. The mean operative time was 278\u2009min, pedicle length 76\u2009\u00b1\u200912\u2009mm, and mean flap weight 247\u2009g. No major complications were seen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The PAP flap can be mapped by CTA in a reproducible way. The <jats:italic>X<\/jats:italic> and <jats:italic>Y<\/jats:italic> axes are based on fixed anatomic landmarks and may form the basis for a banana\u2010shaped flap design of the PAP\u2010flap.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.26703","type":"journal-article","created":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T14:39:04Z","timestamp":1633617544000},"page":"123-133","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Anatomic study of the profunda artery perforators by multidetector CT scanner and clinical use of the banana\u2010shaped flap design for breast reconstruction"],"prefix":"10.1002","volume":"125","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3465-0752","authenticated-orcid":false,"given":"Assaf A.","family":"Zeltzer","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery University Hospital Brussels (VUB)  Brussels 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