{"corpus_id":257962991,"paper_sha":"df6e46ecd392275e01cd2362cc69759fcd1427fd","doi":"10.21037/gs-22-603","arxiv_id":null,"pmid":37200935,"pmcid":"10186161","mag_id":null,"dblp_id":null,"acl_id":null,"title":"Alternative donor sites in autologous breast reconstruction: a clinical practice review of the PAP flap","year":2023,"publication_date":"2023-01-01","venue":"Gland surgery","journal":{"name":"Gland Surgery","pages":"516 - 526","volume":"12"},"journal_issn":null,"journal_title":null,"publication_types":["Review","JournalArticle"],"pubmed_pub_types":["Journal Article","Review"],"s2_fields_of_study":["Medicine"],"reference_count":52,"citation_count":10,"influential_citation_count":0,"is_open_access":true,"arxiv_categories":null,"arxiv_license":null,"arxiv_journal_ref":null,"mesh_headings":null,"chemicals":null,"comments_corrections":null,"source_flags":5,"s2_open_access_pdf_url":"https://gs.amegroups.com/article/viewFile/112343/pdf","s2_open_access_landing_url":"https://www.semanticscholar.org/paper/df6e46ecd392275e01cd2362cc69759fcd1427fd","s2_open_access_license":"CCBYNCND","s2_open_access_status":"GOLD","pmc_open_access_pdf_url":null,"pmc_open_access_landing_url":null,"pmc_open_access_license":null,"pmc_open_access_status":null,"unpaywall_open_access_pdf_url":null,"unpaywall_open_access_landing_url":null,"unpaywall_open_access_license":null,"unpaywall_open_access_status":null,"abstract":"Breast cancer is currently the most common cancer in female patients in the United States and around the world, with over 2 million new cases of breast cancer diagnosed in 2020. Subsequently, breast reconstruction after mastectomy is also becoming increasingly common. While not every patient elects to undergo reconstruction after mastectomy, many patients desire reconstruction with either implant-based or autologous tissue. In certain patients, autologous reconstruction can offer a multitude of advantages over implant-based reconstruction. While abdominally-based free flaps such as the deep inferior epigastric perforator (DIEP) flap have become the flap of choice for breast reconstruction, the profunda artery perforator (PAP) flap is a strong alternative for patients in which abdominally-based flaps are contraindicated or insufficient. This clinical practice review aims to summarizes the history of the PAP flap, describe relevant anatomy and characteristics of the PAP flap that make it a well-suited option in breast reconstruction. It will also provide clinical pearls related to pre-operative preparation, markings, and surgical technique involved in ensuring successful perforator dissection, flap harvest, inset, and survival. Finally, this review will discuss current literature published on PAP flaps to determine post-operative clinical outcomes, complications, and patient reported outcomes associated with PAP flap breast reconstruction.","claims":[{"public_id":"cl_1f114aa25f048702fd0bbcf43cbd25c3","status":"active","text":"Clinical pearls on pre-operative preparation, markings, and surgical technique are provided to support successful perforator dissection, flap harvest, inset, and survival.","confidence":0.91,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_1f114aa25f048702fd0bbcf43cbd25c3"},{"public_id":"cl_a03e59cd8419d1147cf9bfb92e18226d","status":"active","text":"Current literature on profunda artery perforator flaps is discussed to assess post-operative clinical outcomes, complications, and patient-reported outcomes.","confidence":0.93,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_a03e59cd8419d1147cf9bfb92e18226d"},{"public_id":"cl_df74d2293ecf86cde017b4a19d36ec54","status":"active","text":"Relevant anatomy and flap characteristics make the profunda artery perforator flap a well-suited option for breast reconstruction.","confidence":0.87,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_df74d2293ecf86cde017b4a19d36ec54"},{"public_id":"cl_96f47a01bce75f65136d59b75a3e3642","status":"active","text":"The profunda artery perforator flap is a strong alternative for patients in whom abdominally based flaps are contraindicated or insufficient.","confidence":0.97,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_96f47a01bce75f65136d59b75a3e3642"}],"concepts":[{"public_id":"co_124727ae670dece145f5deb5fb601251","status":"active","name":"complications","description":"Adverse events or problems occurring after PAP flap breast reconstruction.","types":["outcome"],"aliases":[],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_124727ae670dece145f5deb5fb601251"},{"public_id":"co_2f35a5b91523a33b64286eb2ff628336","status":"active","name":"current literature","description":"The body of published studies on PAP flaps reviewed for outcomes and complications.","types":["review corpus"],"aliases":["published 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reconstruction.","types":["surgical flap","reconstructive technique"],"aliases":["PAP flap"],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_50ff34965451e1edebf5409c8099bcdb"},{"public_id":"co_84608c1c82c04d0a652ebf5834ac021f","status":"active","name":"surgical technique","description":"The operative methods used for perforator dissection, flap harvest, inset, and flap survival.","types":["method"],"aliases":["operative technique"],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_84608c1c82c04d0a652ebf5834ac021f"},{"public_id":"co_993c830d0a3caaa15bbaa5689f2fe29f","status":"active","name":"patient-reported outcomes","description":"Outcome measures reported directly by patients, such as satisfaction or quality of life.","types":["outcome"],"aliases":["PROs"],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_993c830d0a3caaa15bbaa5689f2fe29f"},{"public_id":"co_b1ab73686e57962fa1cef8981c6f1d82","status":"active","name":"markings","description":"Surface markings used to guide flap design and surgical incision planning.","types":["surgical planning"],"aliases":["pre-operative markings"],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_b1ab73686e57962fa1cef8981c6f1d82"},{"public_id":"co_b7ef2d04c7b7ee3f91d6287aa6940066","status":"active","name":"breast reconstruction","description":"Surgical reconstruction of the breast after mastectomy or breast cancer surgery.","types":["surgical 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