Reconstruction of the anterior chest wall using the internal mammary artery perforator flap (IMAP): About a series of 23 cases.

IMAP Internal mammary artery perforator flap Lambeau en hélice Lambeau perforant de l’artère mammaire interne Propeller flap Reconstruction sternale Reconstruction thoracique Sternal reconstruction Thoracic reconstruction

Journal

Annales de chirurgie plastique et esthetique
ISSN: 1768-319X
Titre abrégé: Ann Chir Plast Esthet
Pays: France
ID NLM: 8305839

Informations de publication

Date de publication:
18 Jun 2024
Historique:
received: 01 11 2023
revised: 15 05 2024
accepted: 23 05 2024
medline: 20 6 2024
pubmed: 20 6 2024
entrez: 19 6 2024
Statut: aheadofprint

Résumé

The advent of propeller flaps has permitted new and less invasive coverage solutions for thoracic defects compared to conventional flaps. Through a retrospective analysis of our cases, we would like to show the advantages of the internal mammary artery perforator (IMAP) flap for anterior chest wall reconstruction. We included patients who underwent anterior chest wall reconstruction with an IMAP propeller flap in the Toulouse University Hospital's plastic surgery department from January 2019 to December 2022. The data were collected on patient data, skin defects, and flap characteristics. Twenty-three IMAP flaps were realized to cover locoregional defects. The skin paddle size of the IMAP flap averaged 15.6cm long (12-20)×6.7cm wide (4-10). The average arc of rotation of the flap was 113.5° (range 70-140°). In 3 cases, the IMAP flap was performed with a superior epigastric artery perforator flap (SEAP). In 3 cases out of 23, the flap partially necrotized, requiring surgical revision. In 1 case, the flap was fully necrotized and had to be removed. Our series of 23 IMAP flaps on thoracic reconstruction is one of the largest published to date. Our series shows that the IMAP flap offers a simple and reliable solution with minor donor site morbidity for reconstructing small to medium-sized defects in the medial and paramedian regions of the chest wall.

Sections du résumé

BACKGROUND BACKGROUND
The advent of propeller flaps has permitted new and less invasive coverage solutions for thoracic defects compared to conventional flaps. Through a retrospective analysis of our cases, we would like to show the advantages of the internal mammary artery perforator (IMAP) flap for anterior chest wall reconstruction.
METHODS METHODS
We included patients who underwent anterior chest wall reconstruction with an IMAP propeller flap in the Toulouse University Hospital's plastic surgery department from January 2019 to December 2022. The data were collected on patient data, skin defects, and flap characteristics.
RESULTS RESULTS
Twenty-three IMAP flaps were realized to cover locoregional defects. The skin paddle size of the IMAP flap averaged 15.6cm long (12-20)×6.7cm wide (4-10). The average arc of rotation of the flap was 113.5° (range 70-140°). In 3 cases, the IMAP flap was performed with a superior epigastric artery perforator flap (SEAP). In 3 cases out of 23, the flap partially necrotized, requiring surgical revision. In 1 case, the flap was fully necrotized and had to be removed.
DISCUSSION AND CONCLUSION CONCLUSIONS
Our series of 23 IMAP flaps on thoracic reconstruction is one of the largest published to date. Our series shows that the IMAP flap offers a simple and reliable solution with minor donor site morbidity for reconstructing small to medium-sized defects in the medial and paramedian regions of the chest wall.

Identifiants

pubmed: 38897881
pii: S0294-1260(24)00055-4
doi: 10.1016/j.anplas.2024.05.003
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 Elsevier Masson SAS. All rights reserved.

Auteurs

L Finelle (L)

Plastic and reconstructive surgery department, University Hospital of Strasbourg, 1, avenue Molière, 67200 Strasbourg, France. Electronic address: lorane.finelle@hotmail.fr.

T Meresse (T)

Plastic and reconstructive surgery department, University Hospital of Toulouse, 1, avenue du Pr-J.-Poulhès, 31400 Toulouse, France.

B Chaput (B)

Plastic and reconstructive surgery department, University Hospital of Toulouse, 1, avenue du Pr-J.-Poulhès, 31400 Toulouse, France.

E Lupon (E)

Plastic and reconstructive surgery department, institut universitaire locomoteur et du sport, Pasteur 2 Hospital, University Côte-d'Azur, Nice, France.

S Gandolfi (S)

Plastic and reconstructive surgery department, University Hospital of Toulouse, 1, avenue du Pr-J.-Poulhès, 31400 Toulouse, France.

Classifications MeSH