Abstract
Background The thoracodorsal artery perforator (TDAP) flap is a versatile pedicled and free
flap with low donor site morbidity and a relatively thin skin paddle. Physical patient
characteristics may influence interindividual differences in perforator characteristics
and, therefore, help to estimate the safety of the TDAP flap.
Methods Dynamic infrared thermography and color duplex ultrasound were applied to assess
the TDAP diameter, peak systolic velocity (PSV), end-diastolic velocity, resistance
index, and thickness of the latissimus dorsi muscle and the subcutaneous tissue bilaterally
in 25 subjects. The effect of handedness on the symmetry of perforator characteristics
was investigated.
Results Perforator properties were not significantly altered by sex or body mass index. The
mean latissimus dorsi muscle thickness correlated positively with both the perforator
diameter (Pearson's r = 0.25, p = 0.0048, n = 124) and the PSV (r = 0.29, p = 0.0012, n = 124). In contrast, a negative correlation was observed between subcutaneous tissue
thickness and PSV (r = −0.31, p = 0.0003, n = 124). A comparison of the perforator diameter and the PSV in the dominant and nondominant
sides showed no statistically significant difference.
Conclusion The findings of the study indicate that perfusion of the thoracodorsal artery flap
is enhanced by the presence of a thicker latissimus dorsi muscle, a thinner subcutaneous
tissue, and a reduced quantity of TDAPs.
Keywords
TDAP flap - latissimus dorsi musculocutaneous flap - perforator - color duplex ultrasound
- perforator diameter - perforator flow velocity
