Perforator flaps based on the pectoral branch of the thoracoacromial artery: anatomical basis using 24 dissections

Abstract

Objectives: A perforator flap based on the pectoral branch of the thoracoacromial artery (TAA) is an attractive option, both in terms of the regional coverage possibilities and the reduced donor site morbidity. And yet this technique has been little documented in the literature. The authors report a series of dissections in order to understand the realization and the indications of this surgical technique. Methods: We dissected 24 perforator flaps based on the pectoral branch of the TAA in cadaver specimens preserved in a glycerin-rich, formalin-free solution. The TAA was first injected with methylene blue. The vascular territory, location of perforators relative to known landmarks, along with the flap’s potential amplitude and arc of rotation were studied. Results: The main perforator arteries were in the middle of the deltopectoral groove length; they were surrounded by adipose tissue in 80% of specimens. Two perforator arteries were found in two specimens: one was in the middle of the deltopectoral groove length and the other was more proximal. The flap’s arc of rotation made it possible to reach the anterior cervical region, the sternal region and the axillary region in every specimen. Conclusion: Through an anatomical study of perforator flaps based on the TAA, we reviewed the principles and landmarks that can be used by plastic surgeons to easily carry out this surgical technique.

Keywords

• dissection
• pectoral branch
• perforator flap
• thoracoacromial artery

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