Perforator flap

A perforator flap is a flap consisting of skin and subcutaneous tissue that is perfused by an isolated artery and vein that perforates the deep tissues (muscle or fascia). From: Plastic Surgery Secrets Plus (Second Edition), 2010. Download as PDF Perforator flap surgery was described as extravagant and exceptional in those days but it has now become the mainstream reconstructive technique for restoring defects throughout the body. What started as a small meeting among friends, has grown into a major international forum where colleagues share their new ideas in the field of perforator flap surgery

Perforator Flap - an overview ScienceDirect Topic

Perforator flaps are a relatively recent addition to our reconstructive techniques. They have evolved as a result of meticulous studies of vascular blood supply to the skin, which have demonstrated a rich network of perforator vessels arising from all major vessels, allowing for the elevation of safe and customized flaps based on these vessels V-Y perforator flaps V-Y flaps have been designed and utilized for reconstruction over the face, trunk, and extremities. Although first described based on a random pattern blood supply, they can also be designed along a single perforator. This increases the reach of the flap as well as the mobility when the flap is isolated on a single perforator Perforator Flaps (PF) surgery, are a new and innovative surgical technique, that, unlike secondary wound healing, allows a single stage reconstruction at the same time as skin excision without its disadvantages.: prolonged healing time, with multiple painful dressings (costs) retractile scar with reduction of the range of motion, dyschromia, unstable and fragile scar The keystone perforator island flap (KPIF) is a versatile flap that was originally described by Behan for reconstruction of defects after excision of skin cancer, and has since been used for the reconstruction of defects located on the head and neck, trunk, and extremities

The anterolateral thigh flap can be considered to be one of the workhorses of perforator flaps. Its ease of dissection together with the long and reliable pedicle make it extremely suitable as a free-skin flap The flap is based medially and is supplied by perforating branches from the internal mammary artery. 16 The classic dissection of the flap was a subfascial dissection extending to within 2 cm of the sternal border. 17 This would incorporate the internal mammary perforators that supply the flap

Perforator Flap

Thoracodorsal artery perforator flap. The thoracodorsal artery perforator (TDAP) flap is based on the branches of the thoracodorsal artery as they pass through the latissimus dorsi to perfuse the overlying soft tissue. This flap is the equivalent of the latissimus myocutaneous flap without the inclusion of the musculature of the latissimus The flap is usually elevated from lateral to medial and the search for perforators is begun when the territory of the rectus sheath over the lateral rectus muscle is reached. This dissection can be performed with the electrocautery on a low setting, or with bipolar forceps and scissors This video demonstrates the versatility of the Superficial Circumflex Iliac Artery Perforator (SCIP) Flap as a reconstructive option.The patient has given wr.. 08:45 - 09:00. Anatomical Basis of Perforator Flaps (Non-Face) Presenters: Steve MORRIS & Mark ASHTON. 09:00 - 09:15. The Facial Artery, the Biggest Perforator Vessel of the Body Presenters: Ian TAYLOR & Mark ASHTON. 09:15 - 09:30. 3D Planning of Complex Surgery of the Face Presenters: Hubert VERMEERSCH & Jan DE CUBBER. 09:30 - 09:45

Breast Reconstruction Perforator Flaps - PubMe

Inclusion of 2 perforators could render the flap safer and increase its skin paddle, making it suitable for larger defects. The pedicled MSAP flap represents a versatile option in soft-tissue defect coverage of the lower leg and around the knee joint Chest wall perforator flaps in partial breast reconstruction after breast conservation surgery: an additional oncoplastic surgical option. Sanjit Kumar Agrawal 1, Sudip Ratna Shakya 1, Shashank Nigam 1, Abhishek Sharma 1, Soumitra S Datta 2,3 and Rosina Ahmed 1. 1 Department of Breast Oncosurgery, Tata Medical Center, Kolkata 700156, India. 2 Department of Palliative Care and Psycho-Oncology.

Lumbar artery perforator flaps (LAPs) have been progressively developed and make it possible to solve very complex situations. We report a multicenter study on LAP performed to treat medium and low lumbar defects of various etiologies, to highlight the versatility of this flap as well as its robustness and reproducibility outline of a dissection of MSAP flap from left calf for oral tongue recopnstrcutio Perforator Flap Reconstruction. Advanced microsurgical techniques make it possible to restore the natural shape and feel of a woman's breast by transplanting her own living tissue from another part of her body. This procedure has lifelong results and is referred to as a perforator flap reconstruction, also known as free flap reconstruction The following images are from an actual patient treated by Dr. Elisabeth Potter who has undergone Lateral Thigh Perforator Flap (LTP Flap) Reconstruction surgery. Before After This is a 39-year-old Female with prior history of left breast cancer who underwent unilateral mastectomy with no reconstruction and adjuvant radiation therapy in 2017.

Perforator Flaps: Anatomy, Technique, - MedOne, Thiem

Breast Reconstruction Perforator Flaps Articl

The LD perforator flap is a typical example of thin perforator flap and it can be used widely as a resurfacing tool or reconstructive modality with various composition The first profunda artery perforator flap was performed for breast reconstruction at the International Course on Perforator Flaps in Mexico City in 2010. The posterior thigh tissue is bounded by the iliotibial tract and adductor muscles horizontally, and the gluteal fold and popliteal fossa vertically Submental flaps for facial and intraoral defect coverage were first described in 1993. These flaps are based on the submental artery, a branch of the facial artery, and have an anterior neck skin paddle which can be an inconspicuous donor site [8, 9].Nasolabial flaps were the first true perforator flaps in the face used to reconstruct perioral defects Medial sural artery perforator flap—indications, tips and pitfalls Aakshay Gulati, Prakash Patel, Nikhil Maini, Daniel Butler, Jagtar Dhanda, Brian Bisase, Paul Norris Article Option A newer procedure, deep inferior epigastric perforator (DIEP) flap, is similar to an msTRAM flap, but only skin and fat are removed. Most of the abdominal muscle is left in place and minimal muscle tissue is taken to form the new breast mound. Reattaching blood vessels requires expertise in surgery through a microscope (microsurgery)

The profunda artery perforator flap - Microsurgeon

Perforator flap definition of perforator flap by Medical

Currently, the perforator vascular flap is increasingly being used to repair sacral wounds 8,9; however, the operation is complicated, and it is still difficult to repair large bedsores. We have modified the perforator vascular flap and designed the clover-style fasciocutaneous perforator flap for the repair of massive sacral pressure sores Introduction. The deep inferior epigastric perforator (DIEP) flap was initially described by Koshima as a muscle sparing variation of the transversus abdominis myocutaneous (TRAM) flap for reconstruction throughout the body, including head and neck and extremity wounds (1,2).It was soon thereafter described for use in breast reconstruction for patients with breast cancer (3-5) The perforator flap is a kind of flap that survives due to the blood supply from perforator vessels with small diameters (approximately 0.5 mm). Unlike other traditional flaps, the perforator flap does not depend on muscle or deep fascia and reduces the morbidity of the donor area to the minimum. Therefore, the use of this flap is an inevitable. Based on these observations, we offer our patients at the Gustave Roussy Institute (Villejuif, France) a thoracodorsal artery perforator (TDAP) free flap including the motor nerve of the latissimus dorsi and vascularized by the thoraco-dorsal pedicle, thus allowing reconstruction in a single surgery

Introduction: The anterolateral and anteromedial thigh (ALT and AMT) flaps are the most commonly used thigh free flaps for intraoral reconstruction.Recently, the profunda artery perforator (PAP) flap has been proposed as an alternative. This study aimed to compare the thickness of these thigh flaps and to identify the factors influencing flap thickness in our population Nugent M, Endersby S, Kennedy M, Burns A (2015) Early experience with the medial sural artery perforator flap as an alternative to the radial forearm flap for reconstruction in the head and neck. Br J Oral Maxillofac Surg 53 (5):461-463. doi: 10.1016/j.bjoms.2015.02.023 CrossRef PubMed Google Scholar. 407 The flap is raised in the distal to proximal direction; once the lateral border of the LD is approached and the perforators of the descending branch are visualized, the muscle containing the perforators is sectioned-muscle sparing technique ; the flap can be turned over or rotated to the breast area. This technique is a variation of the. Program Thursday, August 24, 2017 Cadaver Labs Cadaver Lab Dissection The Ohio State University Hamilton Hall Room 256/258 Columbus, OH 43210 (Shuttle service provided from Grand Event Center to Hamilton Hall, 7:15am and 7:30am. Return shuttle service from Hamilton Hall to Grand Event Center, 3:00pm) 8:00-10:00am ALT Flap - Pierfrancesco Cadenelli, M.D. SCIP - J Project Description. This animated video, intended for surgical fellows in the field of Ear, Nose and Throat, or ENT, surgery, introduces viewers to the surgical procedure for a thoracodorsal artery perforator flap harvest technique.Resecting tumours of the head and neck may require a skin graft to be harvested from another part of the patient to repair tissue loss


Facial Artery Perforator Flap Plastic Surgery Ke

  1. A perforator flap is a flap that includes skin and subcutaneous tissue, which is perfused by a cutaneous perforator that perforates muscle or fascia. For decades, perforator flap surgery has been widely used in the field of repair/reconstructive surgery to conceal skin and soft tissue defects due to trauma or following tumor extirpation by.
  2. The anterolateral thigh flap involves the skin paddle, the descending branch pedicle of the lateral circumflex femoral artery, and the perforators to the skin paddle. The descending branch pedicle is situated between the rectus femoris and vastus lateralis muscle. The major perforators to the skin paddle are normally located within a 2 to 3 cm.
  3. The Lumbar Artery Perforator Flap in Autologous Breast Reconstruction: Initial Experience with 100 Cases. Plast Reconstr Surg. 2018 Jul. 142 (1):1e-8e. . Hamdi M, Spano A, Van Landuyt K, D'Herde K.
  4. The keystone perforator island flap (KPIF) was described by Behan in 2003 as a curvilinear trapezoidal shaped flap, representing the architectural shape of the keystone in Roman arches, relying on randomly fasciocutaneous or musculocutaneous perforators. It representing two opposing V-Y flaps joined together, with a flap width at a 1:1 ratio to.
Free Medial Sural Artery Perforator Flap - YouTubeA reappraisal of the surgical planning of the superficial

Evolution of local perforator flaps in lower extremity

  1. International Oldenburg-Groningen Perforator Flap Course. 512 likes. A unique opportunity to learn perforator flap harvesting and lymphatic microsurgery using state-of-the-art facilities and fresh..
  2. The palmar artery perforator flap is based on multiple fasciocutaneous perforators that arise from the ulnar palmar digital artery of the little finger . Several options should be considered before undertaking fingertip reconstructions following Zone I injuries, even in cases with modest deficits
  3. As a perforator or adipocutaneous flap, the flap is reliable and easy to raise, and spares donor site morbidity AB - Introduction?To reduce donor site morbidity in anterior chest wall reconstruction, a flap based on perforators of the superior epigastric artery (SEA) was developed and successfully applied in a pedicled fashion for locoregional.
  4. The superficial circumflex iliac artery perforator flap in intra-oral reconstruction Published in Journal of Plastic, Reconstructive & Aesthetic Surgery in December, 2013 Web of Science (Free Access) View full bibliographic record View citing articles.
  5. Multiterritory perforator flap is an important plastic surgery technique, yet its efficacy can be limited by partial necrosis at the choke Ⅱ zone. Butylphthalide (NBP) has been used for many diseases but has not been studied in the multiterritory perforator flap. With the effect of NBP, we observed increasing in capillary density, inhibition of autophagy and oxidative stress, and a reduction.
  6. Project Description. This animated video, intended for surgical fellows in the field of Ear, Nose and Throat, or ENT, surgery, introduces viewers to the surgical procedure for an anterolateral thigh perforator flap subfascial harvest technique.Resecting tumours of the head and neck may require a skin graft to be harvested from another part of the patient to repair tissue loss
  7. The serratus artery perforator (SAAP) flap can be based on a septal or intramuscular perforator of the SA branch of the TD pedicle (Figure 3). Furthermore, vascular connection between the intercostal perforators and the serratus anterior (SA) branch is found in 21% of cases allowing to harvest the intercostal perforator flaps with the SA branch.

Perforator Flaps for Axillary Hidradenitis Suppurativa

The posterior wall of the vagina was found missing during the operation. An IGAP flap was used for reconstruction of the posterior wall of the vagina and a superior gluteal artery perforator (SGAP) flap was used for reconstruction of the posterior perineal skin defect (figures 1-5) The gluteal artery perforator flap was first described by Koshima in 1993 [4] and has gained popularity recently [3,7,15]. The dissection of the perforator can lead to a pedicle length of 8-10 cm [5]. A long vascular pedicle also means there is greater mobility of the flap and tension free closure

Perforator anatomy of the ulnar forearm fasciocutaneousThe Deep Inferior Epigastric Perforator Flap for Breast

Keystone and Pedicle Perforator Flaps in Reconstructive

This series demonstrates that keystone perforator flap closure allows the thigh to maintain a relatively normal appearance, reduces postoperative pain associated with skin grafting, and can be performed in higher BMI patients with minimal complications and without increasing operative time or sensory or motor deficits 09:15 Flap raising and closure. Case description. The skin island lies atop the latissimus dorsi muscle, and is supplied by a myocutaneous perforator, arising from the descending branch of the thoracodorsal pedicle. The anterior margin of the latissimus dorsi is palpated and marked on the skin surface. The perforator is most likely to be found.

Salvage of Difficult Chest Wall and Epigastric Defects

Procedure: This video depicts the abdominal closure and flap inset for a delayed bilateral deep inferior epigastric perforator (DIEP) flap reconstruction in a 53-year-old patient status post bilateral mastectomy for breast cancer.. Introduction: The DIEP flap is an autologous form of breast reconstruction following mastectomy, which can allow single-stage reconstruction in contrast to tissue. A perforator flap is a type of skin flap or subcutaneous flap that is supplied by one (or more) perforator blood vessels that branch from a deeper blood vessel. The isolated perforator is moved and freely dissected together with the overlying tissue, enabling the flap to be moved Lateral intercostal artery perforator (LICAP) flap for breast volume augmentation provides the benefits of addressing axillary tissue excess and avoiding intramuscular dissection. Previous experience with the LICAP flap in patients with prior breast conservation therapy (BCT) has led to the development of an extended version for massive weight.

Successful Use of Intercostal Muscle Flap in Cavitary Lung

Perforator Flaps: The Anterolateral Thigh Flap for Lower

  1. BACKGROUND: Chimeric flaps are often used in reconstructive fields for multiple defects, different functional defects, and extensive defects. In this article, we present the results of the use of thoracodorsal artery perforator (TDAp) chimeric flaps including a latissimus dorsi (LD) or serratus anterior (SA) muscle to prevent pedicle compression for lower extremity reconstruction
  2. Lateral Intercostal Artery Perforator (LICAP) flap breast reconstruction is suitable for some patients whose breast cancer is in the outer part of the breast. The procedure aims to replace the lost breast tissue (removed at the time of cancer surgery) with skin and fat from under your arms and restore the size and shape of your breast
  3. Local perforator flaps have the particular challenge of design and execution having to be centred on the perforator vessels. In the lower limb the main perforators arise from the three major vessels - the posterior tibial, the peroneal and the anterior tibial arteries. In my experience the perforators arising from the first two are easier one
  4. PACIENTES PERFORATOR. THURSDAY. 11/08/2018 CLAUDIA ZAMIRA ABUSAID • ID: CC 39686417 • 55 Y.O • CHIEF COMPLAINT: breast asymmetry • Hypertension, liposuction rhynoplasty, hysterectomy. • PREVIOUS MEDICAL RECORD: - right breast in situ ductal carcinoma - (02/2018) Lumpectomy + Radiotherapy - MY RISK study PALB2 + CLAUDIA ZAMIRA ABUSAID • PHYSICAL EXAMINATION: - Ptotic breasts.

The aims of this Atlas are to introduce the clinical applications of perforator flaps in plastic surgery and skin replacement. After a brief introduction of the concept and surgical rationale of perforator flaps, the book presents 24 different flaps from donor sites including upper limb, lower lim Perforator flaps meet these goals & are the result of over 30 yrs of evolution in flap refinement & design. Since the original description of radial forearm flap in 1978 by Yang & Yuzhi [1] & Timmons anatomical description in 1986, this versatile flap has found numerous applications in plastic & reconstructive surgery [2] . Its value in head. ] as a multi perforator advancement flap with the advantages of providing a reliable, safe flap harvest that can minimize donor site morbidity and obviate the need for microsurgical techniques. To the best of our knowledge, this is the first report of the use of a keystone perforator island flap for defect closure after conjoined twin separation Perforator Flaps: Anatomy, Technique, & Clinical Applications is the first major work on the design and use of perforator flaps in reconstructive surgery. It marks a new era in reconstructive surgery where surgeons are no longer bound by the traditional conventions of flap surgery Reconstruction of composite defects of the posterior thigh and knee is challenging. Pedicled medial gastrocnemius flaps are the traditional reconstructive approach, but late contractures related to skin grafted muscle may affect knee function. More recently, the medial sural artery perforator (MSAP) flap has been described for such defects, although may necessitate skin grafting of the donor site

A Scapholunate Ligament–Sparing Technique Utilizing the

artery (DIEA) perforator flaps has become the mainstay for breast reconstructive surgery. CT angiography and three-dimensional image post processing can depict the number, size, course and location of the DIEA perforating arteries for the pre-operativ 4. Anteromedial thigh flap Femoral artery lies in subsartorial canal for its lower 2/3, and in this portion gives off muscular and fasciocutaneous branches Perforators pass around both borders of sartorius to form a plexus at the level of the deep fascia with an axis along the border of sartorius Range in size from 0.5-1mm Ø 80% cases the.

Perforator Flaps: Perforator Flaps in Head and Neck

Superior Gluteal Artery Perforator Flap (SGAP) The tissue flap taken from the buttock region includes the skin, fatty tissue and underlying blood vessels. Depending on where you have the most tissue, the flap can be taken from one of two areas: the upper portion of the buttock, which is supplied by the blood vessels known as the superior. Deep inferior epigastric artery perforator (DIEP) flap is one of the most common breast reconstruction procedures done after a mastectomy. 1  The DIEP flap procedure uses skin and tissue (no muscle) from the abdomen to create a new breast mound. This procedure is a form of autologous reconstruction , a surgery that uses your own tissue

DIEP flap perforators and prophylaxis—X marks the spot

Perforator Flap Breast Reconstruction: Background, History

  1. DIEP Flap uses blood vessels (deep inferior epigastric perforators) and skin and fat from the lower abdomen to reconstruct a breast after mastectomy. Perforator flaps represent the state of the art in breast reconstruction. Replacing the skin and soft tissue removed at mastectomy with soft, warm, living tissue is accomplished by borrowing skin.
  2. The perforator artery may be intact, but the tenuous venae comitantes are easily injured and can result in flap failure owing to venous congestion. Morbidity: This flap requires division of some dorsal sensory branches during flap elevation. This will result in loss of sensation in the territory of the nerve and, rarely, a painful neuroma
  3. Perforator flap design begins with understanding the anatomy based on the territories described above. Perforator territories in the lower extremity Posterior tibial perforators The posterior tibial artery is the continuation of the popliteal artery as it exits the popliteal fossa and i
  4. Deep inferior epigastric perforator (DIEP) flaps have become the state of the art in breast reconstruction. We compared the diagnostic performance of multidetector computed tomography (CTA) and magnetic resonance angiography (MRA) in DIEP flap planning. Twenty-thr
  5. By Phillip N. Blondeel. The book outlines techniques for flap harvest, from the most basic to the highly advanced. This new edition has been updated to include ten new chapters and extensive updates on all existing chapters
  6. perforator flap surgery (3/20) (P < 0.01). The results of this study show that the proportion of patients who develop a seroma following surgical repair of a sacral pressure is lower following perforator than rotation flap surgery. We conclude that, our small sample indicates a perforator flap technique leads to lower complication rates, bu
  7. Perforator Flaps: A Microsurgical Innovation. Add to Watch List; Average Rating: | | « #1 of 3, Added By: An_2019809, MD, Plastic Surgery and Aesthetic Medicine, 4:01PM Nov 25, 2008 DIEP flap is a good cocept and we have used it in our institute several times. I hope your results are better than some of our surgeons as, there is a high failure.

The deep inferior epigastric artery perforator (DIEP) fla

This flap is based on the ascending branch of the dorsal ulnar artery (DUA) . In addition to the ulnar artery perforator, this flap is also nourished by the dorsal carpal arch through its communications with the descending branch. Limits of the flap: We limit the proximal extent of the flap to the mid-forearm. This results in a 10- to 15-cm. Keywords: Propeller flap, perforator flap, local flap, lower limb reconstruction, microsurgery INTRODUCTION Reconstruction of soft tissue defects in the lower limb is known to be difficult due to the lack of spare local tissue in the immediate vicinity of such defects[1]. Traditionally, these defects used to be covered, dependin Pre-Expanded Perforator Flaps, An Issue of Clinics in Plastic Surgery por Lee L.Q. Pu; Chunmei Wang. ISBN: 9780323482882 - Tema: Cirugía Plástica Y Reparadora - Editorial: ELSEVIER LIMITED (UK) - This issue of Clinics in Plastic Surgery, guest edited by Drs. Lee L.Q. Pu and Chunmei Wang, is devoted to Pre-Expanded Perforator Flaps. Articles in. A typical example is the perforator flap from the lower abdomen that is called the paraumbilical perforator flap by some and deep inferior epigastric perforator flap by others. From an anatomical point of view, these flaps are almost identical This series demonstrates that keystone perforator flap closure allows the thigh to maintain a relatively normal appearance, reduces postoperative pain associated with skin grafting, and can be performed in higher BMI patients with minimal complications and without increasing operative time or sensory or motor deficits

The Superficial Iliac Artery Perforator (SCIP) Flap - YouTub

  1. Large area of deep wound in the foot and ankle with bone and tendon exposed. Harvested chimeric anterolateral thigh perforator flappedicled with descending branch of lateral circumflex femoral artery. Place the chimeric anterolateral thigh perforator flap near the wound of the foot and ankle. The chimeric flap was used to fan out on the wound, the muscle flap covers the bone exposed wound
  2. Perforator flaps have gained increasing attention with the realization that the muscle component of the TRAM flap does not add to the quality of the reconstruction and serves only as a carrier for the blood supply to the flap. Thus, the concept of separating the flap (skin, fat, artery, and vein) from the muscle was realized as a means of.
  3. The purpose of the present study was to investigate the possible association between inflammatory responses and choke vessel remodeling in the extended perforator flap model in rats. After flap elevation, the animals were randomly divided into three groups (n=6 in each) for tissue analysis at three, five or seven days after flap surgery

The use of perforator flaps has heralded a new era in reconstructive surgery. Perforator flaps are less bulky than traditional flaps and do not use muscle tissue. These characteristics allow reconstructions using these flaps to achieve the best functional and aesthetic results in both the reconstruction site and the donor site. This issue of Clinics in Plastic Surgery provides guidance to help. The most common methods are implant-based and autologous, or a combination of the two. Following postmastectomy radiotherapy, delayed reconstruction using a deep inferior epigastric perforator (DIEP) flap is increasingly being performed 4, 5. DIEP flap reconstruction is also undertaken as an immediate breast reconstruction (IBR) 4, 6-8 flap perforator vessels anatomy in the Malaysian population is not well-analyzed. The purpose of this study was to determine the distribution of ALT flap perforator vessels and its clinical applications in reconstructive surgery. Methods: This is a retrospective cross-sectional study conducted in two main centers of reconstructive surgery

The purpose of this essay is to illustrate the normal imaging appearance of deep inferior epigastric perforator (DIEP) flap breast reconstruction and common postoperative complications. CONCLUSION Deep inferior epigastric perforator flap (DIEP) reconstruction is a type of breast reconstruction surgery. It essentially involves the transfer of the patient's own skin and subcutaneous tissues from the lower abdominal wall to the chest to form the breast mound The profunda artery perforator (PAP) flap for breast reconstruction originated by Dr. Robert J. Allen in 2010 after multiple failed attempts at using muscle-sparing transverse rectus abdominal muscle (MS-TRAM) flap and implants. This flap method was initially approached due to the patient's request for an autologous tissue graft that did not sacrifice muscle

Program Perforator Flap

Nasolabial flaps have limited mobility and may need two stages, mostly for intraoral defects .The facial artery perforator-based flap is the first true perforator flap in the face. It allows one-stage reconstruction and allows freedom in flap design Pneumoperitoneum for laparoscopic surgery following autologous deep inferior epigastric (DIEP) perforator flap breast reconstruction may prove difficult as a result of loss of abdominal wall compliance. Surgeons should consider the details of the patient's breast reconstructive procedure in order to identify patients at risk for difficult. DIEP (deep inferior epigastric perforators) flap surgery is a cutting-edge breast reconstruction procedure that uses a flap of complete tissue - blood vessels (perforators), skin and fat - from a woman's lower abdomen as donor tissue. The flap is then transferred to the chest where the surgeon, aided by a microscope, will attach the donor. Deep Inferior Epigastric Perforator (DIEP) breast flap reconstruction is an autologous breast reconstruction to be considered for patients who are undergoing a mastectomy. The procedure itself uses a flap of composite tissue - which includes the deep inferior epigastri Multiterritory perforator flap survival is commonly applied in surgical tissue reconstructions and covering of large skin defects. However, multiple risk factors such as ischemia, reperfusion injury, and apoptosis after reconstructive surgeries cause necrosis in distal parts with outcomes ranging from poor aesthetic appearance to reconstructive failure

Flap surgery is a technique in plastic and reconstructive surgery where any type of tissue is lifted from a donor site and moved to a recipient site with an intact blood supply. This is distinct from a graft, which does not have an intact blood supply and therefore relies on growth of new blood vessels.This is done to fill a defect such as a wound resulting from injury or surgery when the. The lateral thigh perforator flap is an excellent option for autologous breast reconstruction, with minimal recipient-site complications. The surgical refinements resulted in a significant reduction of donor-site complications. Therefore, the lateral thigh perforator flap is currently the authors' second choice after the deep inferior. Medial Sural Artery Perforator free flap (MSAP) A Medial Sural Artery Perforator free flap is also known as an MSAP flap. It. comprises of skin, taken from the back of the lower leg which can be used to fill a. hole which is left when a cancer has been removed. It is one of the ways of replacing. tissue in the head and neck