The PUG Flap: Conjoined Profunda Artery Perforator and Upper Gracilis Flap for Breast Reconstruction
Language
English
Publication Date
3-1-2024
Journal
Plastic and Reconstructive Surgery
DOI
10.1097/GOX.0000000000005544
PMID
38528848
PMCID
PMC10962896
PubMedCentral® Posted Date
3-25-2024
PubMedCentral® Full Text Version
Post-print
Abstract
Abdominal-based free flaps are the mainstay of autologous breast reconstruction; however, the region may not be ideal for patients with inadequate soft tissue or history of abdominal surgery. This case describes the use of a novel conjoined flap based on the profunda artery perforator and upper gracilis pedicles, named the perforator and upper gracilis (PUG) flap. This flap design aims to maximize medial thigh flap volume while ensuring robust tissue perforation. Here, we present our experience with the PUG flap in a breast cancer patient undergoing autologous reconstruction. The patient was a 41-year-old woman seeking nipple-sparing mastectomy and immediate autologous reconstruction with the PUG flap due to limited abdominal tissue availability. The gracilis and profunda artery perforator flaps were elevated using one boomerang-style skin paddle. Once harvested, the flaps were inset with antegrade and retrograde flow off the internal mammary arteries and both respective internal mammary veins. The donor site was closed in a V-Y pattern resulting in a thigh lift-type lift and concealed scar. In conclusion, the boomerang-style PUG flap maximizes medial thigh free tissue transfer volume, offers internal blood flow redundancy, and maintains good cosmesis of the donor site.
Published Open-Access
yes
Recommended Citation
Abdulwadood, Isra; Pflibsen, Lacey R; Jarvis, Nicholas R; et al., "The PUG Flap: Conjoined Profunda Artery Perforator and Upper Gracilis Flap for Breast Reconstruction" (2024). Faculty, Staff and Students Publications. 7337.
https://digitalcommons.library.tmc.edu/baylor_docs/7337