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Cirugía Plástica Ibero-Latinoamericana

Print version ISSN 0376-7892


SICILIA CASTRO, D. et al. Optimizing the use of the second intercostal perforator flap of the internal mammary artery. Cir. plást. iberolatinoam. [online]. 2012, vol.38, n.2, pp.145-151. ISSN 0376-7892.

The island flap based on perforators of the internal mammary artery (IMAP flap) is recently used in reconstruction of head and neck defects. The aim of this review is to verify the possibilities of the arc of rotation of the flap when it's necessary to carry out an extensive dissection of the vascular pedicle. We present reconstruction of partial pharyngeal defects in 4 patients, aged between 46 and 75 years and all men, using a pedicle flap based on the second perforator of the internal mammary artery. The average size of the defect was 3.2 cm (SD +/- 1.5 cm) horizontally and 4.5 cm (SD +/- 2.2 cm) vertically. In all cases, an island flap was dissected with an average size of 6 X 8 cm. The average length of the pedicle was 5.5 cm (SD +/- 1.51 cm). In all cases it was possible the sealing of the pharyngeal defect without rib resection or to incorporate part of the corresponding internal mammary artery. IMAP flap is rapid to dissect and allows coverage in case of partial pharyngeal defects from anterior neck to the base of the tongue without needing rib resection or partial incorporation of the mammary vessels.

Keywords : Pharyngeal defects; Reconstruction with flaps; Perforator flaps; Internal mammary artery perforator flap.

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