Volume : 7, Issue : 4, April - 2018

ADD-ON EXTENDED DORSAL INTERCOSTAL ARTERY PERFORATOR PROPELLAR FLAP (AOE-DICAP) FOR THE RECONSTRUCTION OF LARGE POSTERIOR TRUNK DEFECTS

Dr. T. M. Balakrishnan, Dr. Karthikeyan Ganesan, Dr. J. Jaganmohan

Abstract :

<p class="MsoNormal" style="margin-top:0in;margin-right:-51.95pt;margin-bottom:&#10;8.0pt;margin-left:-28.35pt;text-align:justify;line-height:200%"><b style="mso-bidi-font-weight:normal"><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Introduction<o:p></o:p></span></b></p> <p class="MsoNormal" style="margin-top:0in;margin-right:-51.95pt;margin-bottom:&#10;8.0pt;margin-left:-28.35pt;text-align:justify;line-height:200%"><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Reconstruction of large posterior trunk soft tissue defects poses a challenging problem.<span style="mso-spacerun:yes">&nbsp; </span>Until recently, these defects were reconstructed with multiple random pattern flaps, local pedicled muscle flaps and musculocutaneous flaps.The posterior intercostal arteries form the major angiosome of the trunk through multiple perforators to the skin.Some studies in the recent literature have highlighted the reliability of the classical DICAP flap in the posterior trunk reconstruction.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:0in;margin-right:-51.95pt;margin-bottom:&#10;8.0pt;margin-left:-28.35pt;text-align:justify;line-height:200%"><b style="mso-bidi-font-weight:normal"><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Aim: <o:p></o:p></span></b></p> <p class="MsoNormal" style="margin-top:0in;margin-right:-51.95pt;margin-bottom:&#10;8.0pt;margin-left:-28.35pt;text-align:justify;line-height:200%"><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">To determine the efficacy, reliability and clinical outcomes of the add-on extended dorsal intercostal artery perforator propeller flaps (AOE-DICAP)for the reconstruction of large posterior trunk defects.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:0in;margin-right:-51.95pt;margin-bottom:&#10;8.0pt;margin-left:-28.35pt;text-align:justify;line-height:200%"><b style="mso-bidi-font-weight:normal"><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Materials &amp; Methods:<o:p></o:p></span></b></p> <p class="MsoNormal" style="margin-top:0in;margin-right:-51.95pt;margin-bottom:&#10;8.0pt;margin-left:-28.35pt;text-align:justify;line-height:200%"><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Six patients (3 infants and 3 adults) with posterior trunk defects due to variousaetiologies were reconstructed with AOE-DICAP flap. <o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:0in;margin-right:-51.95pt;margin-bottom:&#10;8.0pt;margin-left:-28.35pt;text-align:justify;line-height:200%"><b style="mso-bidi-font-weight:normal"><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Result</span></b><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">:<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:0in;margin-right:-51.95pt;margin-bottom:&#10;8.0pt;margin-left:-28.35pt;text-align:justify;line-height:200%"><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">All flaps survived completely, except for superficial epidermolysis at the distal border of the flap in one patient that healed secondarily. Average follow up was 12 months.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:0in;margin-right:-51.95pt;margin-bottom:&#10;8.0pt;margin-left:-28.35pt;text-align:justify;line-height:200%"><b style="mso-bidi-font-weight:normal"><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Conclusion:<o:p></o:p></span></b></p> <p class="MsoNormal" style="margin-top:0in;margin-right:-51.95pt;margin-bottom:&#10;8.0pt;margin-left:-28.35pt;text-align:justify;line-height:200%"><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Add-on extended DICAP (AOE-DICAP) flap provides an excellent stable cover and a viable option for large median and para-median back defects reconstruction.<o:p></o:p></span></p>