{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T17:50:33Z","timestamp":1770141033032,"version":"3.49.0"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J reconstr Microsurg"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:p>\n            Background\u2003The volume of the profunda femoris artery perforator (PAP) flap limits its indications to small- and medium-sized breast reconstructions after modified radical mastectomy for cancer. We report a modified PAP flap design, including not only a vertical extension that increases its volume but also the skin surface, which suits larger breasts requiring immediate or delayed breast reconstructions and compare the results with our horizontal skin paddle PAP flap experience.<\/jats:p><jats:p>\n            Patients and Methods\u2003In our center between November 2014 and November 2016, 51 consecutive patients underwent a PAP flap breast reconstruction following breast cancer. A retrospective analysis on the collected data was performed to compare 34 patients with a bra cup smaller than C who underwent 41 horizontal PAP flap procedures, with those (n\u2009=\u200917) of a bra cup greater than or equal to C who underwent 21 fleur-de-lys PAP flap procedures. Demographic, anthropometric, flap and surgical characteristics, postoperative complication rates, and hospital stay were compared between the two groups.<\/jats:p><jats:p>\n            Results\u2003The average flap weight was 480\u2009g (range: 340\u2013735 g) for the fleur-de-lys PAP flap group compared with 222\u2009g (range: 187\u2013325 g) for the horizontal PAP flap procedure (p\u2009&lt;\u20090.001). The mean flap dimensions were 25\u2009\u00d7\u200918 cm for the fleur-de-lys PAP flap group compared with 25\u2009\u00d7\u20097 cm in the horizontal PAP flap group. No flap failure was observed in the fleur-de-lys PAP flap group compared with two flap failures secondary to venous thrombosis in the horizontal PAP flap group (NS). Three patients (14%) experienced delayed healing at the donor site compared with four patients (10%) in the horizontal PAP flap group (NS).<\/jats:p><jats:p>\n            Conclusion\u2003The fleur-de-lys skin paddle design not only allows an increase of the horizontal PAP flap volume, but also increases the skin surface, with an acceptable donor site morbidity. For medium- or large-sized breasts, the fleur-de-lys PAP flap seems to be ideal when a DIEP flap-based reconstruction is contraindicated.<\/jats:p>","DOI":"10.1055\/s-0038-1649508","type":"journal-article","created":{"date-parts":[[2018,6,2]],"date-time":"2018-06-02T18:30:53Z","timestamp":1527964253000},"page":"008-014","source":"Crossref","is-referenced-by-count":28,"title":["Medium- and Large-Sized Autologous Breast Reconstruction using a Fleur-de-lys Profunda Femoris Artery Perforator Flap Design: A Report Comparing Results with the Horizontal Profunda Femoris Artery Perforator Flap"],"prefix":"10.1055","volume":"35","author":[{"given":"Martin","family":"Lhuaire","sequence":"first","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, H\u00f4pital Europ\u00e9en Georges Pompidou, Assistance Publique des H\u00f4pitaux de Paris, Universit\u00e9 Paris Descartes, Paris V, Paris, France"},{"name":"Institute of Anatomy and Organogenesis, Facult\u00e9 de M\u00e9decine Henri Warembourg, Universit\u00e9 de Lille II, Lille, France"},{"name":"Department of General and Digestive Surgery, H\u00f4pital Robert Debr\u00e9, Centre Hospitalier Universitaire de Reims, Universit\u00e9 de Reims Champagne-Ardenne, Reims, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Haddad","sequence":"first","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, H\u00f4pital Europ\u00e9en Georges Pompidou, Assistance Publique des H\u00f4pitaux de Paris, Universit\u00e9 Paris Descartes, Paris V, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco-Saverio","family":"Wirz","sequence":"first","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, H\u00f4pital Europ\u00e9en Georges Pompidou, Assistance Publique des H\u00f4pitaux de Paris, Universit\u00e9 Paris Descartes, Paris V, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samah","family":"Abedalthaqafi","sequence":"first","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, H\u00f4pital Europ\u00e9en Georges Pompidou, Assistance Publique des H\u00f4pitaux de Paris, Universit\u00e9 Paris Descartes, Paris V, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D\u00e9borah","family":"Obadia","sequence":"first","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, H\u00f4pital Europ\u00e9en Georges Pompidou, Assistance Publique des H\u00f4pitaux de Paris, Universit\u00e9 Paris Descartes, Paris V, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Derder","sequence":"first","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, H\u00f4pital Europ\u00e9en Georges Pompidou, Assistance Publique des H\u00f4pitaux de Paris, Universit\u00e9 Paris Descartes, Paris V, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandre","family":"Marchac","sequence":"first","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, H\u00f4pital Europ\u00e9en Georges Pompidou, Assistance Publique des H\u00f4pitaux de Paris, Universit\u00e9 Paris Descartes, Paris V, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Benjoar","sequence":"first","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, H\u00f4pital Europ\u00e9en Georges Pompidou, Assistance Publique des H\u00f4pitaux de Paris, Universit\u00e9 Paris Descartes, Paris V, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikael","family":"Hivelin","sequence":"first","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, H\u00f4pital Europ\u00e9en Georges Pompidou, Assistance Publique des H\u00f4pitaux de Paris, Universit\u00e9 Paris Descartes, Paris V, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurent","family":"Lantieri","sequence":"first","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, H\u00f4pital Europ\u00e9en Georges Pompidou, Assistance Publique des H\u00f4pitaux de Paris, Universit\u00e9 Paris Descartes, Paris V, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"Hunsinger","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, H\u00f4pital Europ\u00e9en Georges Pompidou, Assistance Publique des H\u00f4pitaux de Paris, Universit\u00e9 Paris Descartes, Paris V, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2018,6,2]]},"container-title":["Journal of Reconstructive Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0038-1649508.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,1,18]],"date-time":"2019-01-18T03:27:03Z","timestamp":1547782023000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0038-1649508"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,2]]},"references-count":0,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2019,1,4]]},"published-print":{"date-parts":[[2019,1]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0038-1649508","relation":{},"ISSN":["0743-684X","1098-8947"],"issn-type":[{"value":"0743-684X","type":"print"},{"value":"1098-8947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6,2]]}}}