Thin Thoracodorsal Artery Perforator Free Flap for Scalp Resurfacing After Malignant Skin Tumor Excision.

IF 2.2 3区医学 Q1 OTORHINOLARYNGOLOGY

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2026-09-27 DOI:10.1002/hed.70490

Daihun Kang, Suein Lee, Seung Eun Hong, Youn Hwan Kim

{"title":"Thin Thoracodorsal Artery Perforator Free Flap for Scalp Resurfacing After Malignant Skin Tumor Excision.","authors":"Daihun Kang, Suein Lee, Seung Eun Hong, Youn Hwan Kim","doi":"10.1002/hed.70490","DOIUrl":null,"url":null,"abstract":"Background: Scalp defects after malignant tumor excision often require free tissue transfer for durable coverage. The thoracodorsal artery perforator (TDAP) flap remains underused despite its suitability for thin elevation.Methods: Fourteen patients (6 men, 8 women; mean age 62 years) treated with a thin TDAP free flap for scalp resurfacing after malignant tumor excision between 2016 and 2026 were retrospectively reviewed. All flaps were performed by a single surgeon at two institutions.Results: TDAP elevation was completed in 14 of 16 attempts (87.5%); in 2 patients no reliable perforator was found at exploration and a latissimus dorsi flap was raised instead. Diagnoses included squamous cell carcinoma (6), basal cell carcinoma (3), basosquamous carcinoma (2), and single cases of eccrine porocarcinoma, angiosarcoma, and melanoma. Mean flap area was 97 cm2 and pedicle length 9.7 cm; superficial temporal vessels served as recipients, with single-artery, single-vein anastomosis per flap. Mean operative time, including excision, was 134 min. One venous thrombosis was salvaged by re-exploration, one flap showed transient venous congestion that resolved spontaneously, and all 14 flaps survived. Over a mean follow-up of 17 months, one patient with angiosarcoma developed regional and distant recurrence without local recurrence at the reconstructed site.Conclusions: The thin TDAP free flap is a reliable, efficient, and versatile option for oncologic scalp reconstruction.","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/hed.70490","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Scalp defects after malignant tumor excision often require free tissue transfer for durable coverage. The thoracodorsal artery perforator (TDAP) flap remains underused despite its suitability for thin elevation.

Methods: Fourteen patients (6 men, 8 women; mean age 62 years) treated with a thin TDAP free flap for scalp resurfacing after malignant tumor excision between 2016 and 2026 were retrospectively reviewed. All flaps were performed by a single surgeon at two institutions.

Results: TDAP elevation was completed in 14 of 16 attempts (87.5%); in 2 patients no reliable perforator was found at exploration and a latissimus dorsi flap was raised instead. Diagnoses included squamous cell carcinoma (6), basal cell carcinoma (3), basosquamous carcinoma (2), and single cases of eccrine porocarcinoma, angiosarcoma, and melanoma. Mean flap area was 97 cm² and pedicle length 9.7 cm; superficial temporal vessels served as recipients, with single-artery, single-vein anastomosis per flap. Mean operative time, including excision, was 134 min. One venous thrombosis was salvaged by re-exploration, one flap showed transient venous congestion that resolved spontaneously, and all 14 flaps survived. Over a mean follow-up of 17 months, one patient with angiosarcoma developed regional and distant recurrence without local recurrence at the reconstructed site.

Conclusions: The thin TDAP free flap is a reliable, efficient, and versatile option for oncologic scalp reconstruction.

查看原文本刊更多论文

薄胸背动脉穿支游离皮瓣用于恶性皮肤肿瘤切除后头皮置换。

背景：恶性肿瘤切除后的头皮缺损通常需要自由组织转移以持久覆盖。胸背动脉穿支（TDAP）皮瓣尽管适合薄抬高，但仍未得到充分利用。方法：回顾性分析2016年至2016年恶性肿瘤切除术后应用游离TDAP薄皮瓣进行头皮表面重塑的14例患者（男6例，女8例，平均年龄62岁）。所有皮瓣均由同一位外科医生在两个机构完成。结果：16次TDAP升高中14次完成（87.5%）；2例患者在探查时未发现可靠的穿支，改为提起背阔肌瓣。诊断包括鳞状细胞癌（6例）、基底细胞癌（3例）、基底鳞状细胞癌（2例），以及单例内分泌孔癌、血管肉瘤和黑色素瘤。皮瓣平均面积97 cm2，蒂长9.7 cm；以颞浅血管为受体，皮瓣单动脉、单静脉吻合。包括切除在内的平均手术时间为134分钟。1例静脉血栓重新探查恢复，1例皮瓣出现短暂性静脉充血后自行消退，14例皮瓣全部成活。在平均17个月的随访中，1例血管肉瘤患者发生了局部和远处复发，而在重建部位没有局部复发。结论：薄TDAP游离皮瓣是一种可靠、高效、多功能的肿瘤头皮重建选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.