Free Thoracodorsal Artery Perforator Flap for Lower Leg and Foot Reconstruction

The thoracodorsal artery perforator flap was first described in 1995. Previous authors presented its versatility in soft tissue reconstruction and resurfacing defects. In our study, we used free thoracodorsal artery perforator flap for reconstruction of lower leg and foot defects in 4 patients. We used color Doppler device to evaluate the course of thoracodorsal artery and its skin perforators preoperatively, and 4 flaps were performed. We harvested only skin and subcutaneous tissue, and preserved the latissimus dorsi muscle and its motor nerve. The largest skin paddle size was 18×7.5 cm. All defects were reconstructed successfully. One flap recipient site encountered wound infection. The complication was resolved with a period of wound care, and it didn't compromise the vitality of the flap. Preoperative color Doppler study facilitates identification of skin perforators, thus simplifies the procedure. The thoracodorsal artery perforator flap is a feasible choice for lower leg and foot reconstruction.