{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T11:28:16Z","timestamp":1779103696571,"version":"3.51.4"},"reference-count":26,"publisher":"Georg Thieme Verlag KG","issue":"06","license":[{"start":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T00:00:00Z","timestamp":1698969600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Indian J Plast Surg"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003We describe our experience with use of free thoracodorsal artery perforator (TDAP) flap for head and neck (H&amp;N) cancer reconstruction, with respect to the patient and disease profile, suitable defect characteristics, the reconstructive technique, and complications.<\/jats:p><jats:p>\n          Methods\u2003Consecutive patients (N\u2009=\u200926) undergoing free TDAP flap for H&amp;N onco-reconstruction, in a single center, were included from January 2015 to December 2018 and the data were analyzed.<\/jats:p><jats:p>\n          Results\u2003Perforator(s) were reliably predicted preoperatively, using handheld Doppler. Lateral position was comfortable for the harvest. Twenty flaps were harvested on a single perforator, more commonly musculocutaneous (n\u2009=\u200916). The thoracodorsal nerve and latissimus dorsi muscle could be preserved, completely in almost all cases. The skin paddle was horizontally (n\u2009=\u20095) or vertically (n\u2009=\u200921) oriented, both giving a satisfactory scar. The flap was used as a single island or two islands by de-epithelializing intervening skin. Pedicle length was sufficient in all cases. Four cases were explored for suspected venous insufficiency. Two had thrombosis, of which one was salvaged, while the other necrosed. One flap had minimal partial necrosis, which was managed with secondary suturing. The 5-year follow-up showed good oral competence, mouth opening, and cosmetic satisfaction among patients.<\/jats:p><jats:p>\n          Conclusion\u2003TDAP flap provides all the advantages of a perforator-based free flap and of back as a donor site with close color match to the face, relatively hairless, and thickness in between the thigh and the forearm. It can be a useful tool to provide an ideal functional and aesthetic outcome, with a hidden donor site and minimal donor site morbidity in selected cases.<\/jats:p>","DOI":"10.1055\/s-0043-1776361","type":"journal-article","created":{"date-parts":[[2023,11,4]],"date-time":"2023-11-04T00:38:01Z","timestamp":1699058281000},"page":"499-506","source":"Crossref","is-referenced-by-count":6,"title":["Free Thoracodorsal Artery Perforator Flap for Head and Neck Reconstruction: An Indian Experience"],"prefix":"10.1055","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2321-5776","authenticated-orcid":false,"given":"Samreen","family":"Jaffar","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0457-8988","authenticated-orcid":false,"given":"Dushyant","family":"Jaiswal","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1775-9967","authenticated-orcid":false,"given":"Vinay Kant","family":"Shankhdhar","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9027-0121","authenticated-orcid":false,"given":"Ameya","family":"Bindu","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0691-2660","authenticated-orcid":false,"given":"Saumya","family":"Mathews","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0396-3526","authenticated-orcid":false,"given":"Mayur","family":"Mantri","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vineet","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prabha Subhash","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Sir H.N. Reliance Foundation Hospital and Research Centre, Girgaon, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,11,3]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1002\/jso.24545","article-title":"Head and neck cancers in India","volume":"115","author":"M Dandekar","year":"2017","journal-title":"J Surg Oncol"},{"issue":"07","key":"ref2","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1097\/00006534-199512000-00014","article-title":"Latissimus dorsi musculocutaneous flap without muscle","volume":"96","author":"C Angrigiani","year":"1995","journal-title":"Plast Reconstr Surg"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1097\/01.prs.0000176253.42394.7c","article-title":"The vascular basis of the thoracodorsal artery perforator flap","volume":"116","author":"B P Thomas","year":"2005","journal-title":"Plast Reconstr Surg"},{"issue":"09","key":"ref4","doi-asserted-by":"crossref","first-page":"3166","DOI":"10.1016\/j.bjps.2022.06.016","article-title":"Three-dimensional visualization of thoracodorsal artery perforators using photoacoustic imaging\u2730,\u2730\u2730","volume":"75","author":"H Shimizu","year":"2022","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1097\/01.SAP.0000054189.14799.F3","article-title":"The thoracodorsal artery perforator flap: anatomic basis and clinical application","volume":"51","author":"C Heitmann","year":"2003","journal-title":"Ann Plast Surg"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"1632","DOI":"10.1097\/PRS.0b013e31816c3bfa","article-title":"Surgical technique in pedicled thoracodorsal artery perforator flaps: a clinical experience with 99 patients","volume":"121","author":"M Hamdi","year":"2008","journal-title":"Plast Reconstr Surg"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1097\/01.prs.0000436843.15494.ad","article-title":"Total breast reconstruction using the thoracodorsal artery perforator flap without implant","volume":"133","author":"F Santanelli","year":"2014","journal-title":"Plast Reconstr Surg"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1055\/s-0039-3400688","article-title":"Thoracodorsal artery perforator and superior epigastric artery perforator flaps for volume replacement oncoplastic breast surgery","volume":"52","author":"D Jaiswal","year":"2019","journal-title":"Indian J Plast Surg"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1002\/micr.22504","article-title":"A thoracodorsal artery perforator chimeric free flap for prevention of microvascular pedicle compression in lower extremity 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