Single vertical incision thoracoabdominal flap for chest wall reconstruction following mastectomy of locally advanced breast cancer
10.4174/astr.2019.97.4.168
- Author:
Kyunghyun MIN
1
;
Eun Jeong CHOI
;
Yeon Hoon LEE
;
Jin Sup EOM
;
Byung Ho SON
;
Sei Hyun AHN
;
Eun Key KIM
Author Information
1. Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. nicekek@korea.com
- Publication Type:Original Article
- Keywords:
Breast neoplasms;
Chest wall;
Inflammatory breast neoplasms;
Reconstructive surgical procedure;
Surgical flaps
- MeSH:
Breast Neoplasms;
Breast;
Demography;
Humans;
Inflammatory Breast Neoplasms;
Length of Stay;
Mastectomy;
Outpatients;
Radiotherapy;
Reconstructive Surgical Procedures;
Retrospective Studies;
Shoulder;
Skin;
Surgical Flaps;
Thoracic Wall;
Thorax;
Tissue Donors;
Transplants;
Wound Healing;
Wounds and Injuries
- From:Annals of Surgical Treatment and Research
2019;97(4):168-175
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Skin grafts have been widely used in managing extensive chest wall defects after mastectomy for advanced breast cancer. However, their durability and tolerability to radiotherapy is still controversial. A thoracoabdominal (TA) flap with a few technical refinements can safely transfer a larger flap while minimizing complications. METHODS: From January 2007 to February 2018, a retrospective review was performed to compare 2 groups after wide breast excision: skin graft group (group 1) and lateral-based, single vertical incision rotation-advancement TA flap (group 2). Patients' demographics, operative details, complications, hospital stay, postoperative outpatient visits, cost, and start of adjuvant therapy were analyzed between the 2 groups. RESULTS: During the study period, 34 patients received skin graft and 41 patients received TA flap. group 2 had a shorter hospital stay (6.41 ± 2.64 days vs. 12.62 ± 4.60 days, P < 0.001) and shorter time to complete wound healing (29.27 ± 18.68 days vs. 39.24 ± 27.70 days, P = 0.03) than group 1. There was also a difference in the period from surgery to initiation of adjuvant therapy (group 1, 45.04 days ± 17.79 days; group 2, 37.07 ± 15.38 days, P = 0.073). Although limitation in shoulder motion was more frequent in group 2, limitation of motion for >1 year was observed in 4 patients in only group 1 (43.90% vs. 38.24%, P = 0.613). CONCLUSION: TA flap has a simple design that minimizes concerns involving the donor site. Moreover, it does not require complicated procedures and allows for re-elevation whenever necessary. Finally, it guarantees faster wound recovery than skin graft with fewer complications.
