Touch Surgery Simulation - PAP Flap

Google Play https://app.adjust.com/3qcbuk

This Touch Surgery Virtual Surgery Simulation demonstrates how to perform a PAP Flap procedure.

Perforator flaps are commonly used for breast reconstruction post mastectomy. A PAP flap is an alternative donor site for those women who have limited abdominal tissue or have had previous abdominal surgery. The donor tissue is obtained from the posterior thigh, utilizing the profunda artery and vein as the vessels for re-attachment.

The adductor muscles and the iliotibial tract transversely enclose the tissue in the posterior thigh. Vertically, the gluteal fold and the popliteal fossa enclose the tissue. In this case the area used for the flap will be of a semi-elliptical shape 1 cm below the gluteal crease with a height of 6 cm. The profunda femoris artery is usually found 6 cm below the gluteal crease, and once in the posterior compartment gives off it three main perforators.

The benefits of using the PAP flap include:
-The profunda artery is lengthy (up to 13 cm) and robust, which makes for ease of reattachment of vessels at the recipient site.
-The ellipse shape of the PAP flap creates a cone, which is ideal for breast contour and shape.
-The donor site dissection avoids inguinal lymphatics to reduce lymphedema and seroma risk.
-The donor site dissection preserves muscle function through the transfer of only skin and fat.
-The donor site scar is well hidden in the crease of the gluteal fold and upper thigh.

Authors:
Dr. Robert J. Allen , M.D., is the pioneer of the muscle sparing DIEP/SIEA/GAP/PAP/LTP perforator flaps and founder of the Group for the Advancement of Breast Reconstruction. As a plastic surgeon, he has an interest in autogenous breast reconstruction and microsurgery. He believes that all women have the chance tNYU PAP Flap Authors Touch Surgery VIrtual Surgeryo keep their muscles and still have natural breasts after breast cancer. Dr. Allen has limited his practice to microsurgical breast reconstruction for the past ten years. Dr. Allen received a medical degree from the Medical University of South Carolina. He then went on to residency at Louisiana State University in general and plastic surgery. After completion of general and plastic surgery training in Louisiana, he moved to New York City for a one-year fellowship in microsurgery at New York University Medical Center. He is Clinical Professor of Plastic Surgery at NYU Medical Center, Medical University of South Carolina, and LSU Health Sciences Center.

Dr. Ali Sadeghi , MD, FACS is a double board-certified plastic surgeon and reconstructive microsurgeon specializing in cosmetic and reconstructive breast surgery for women. At his unique location in uptown New Orleans, Dr. Sadeghi provides leading-edge techniques to his patients to achieve astoundingly naturally beautiful results in aesthetic, restorative, and reconstructive breast surgery. Dr. Sadeghi focuses on providing his patients with compassionate and individualized care in the most welcoming environment.

Music credit:
Distant Shore - OverHertz