Thoracodorsal Artery Perforator Diameter and Flow Velocity Correlate with Muscle Thickness.

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.