Flaps with Skin Islands for Managing Skin Defects after Breast Conserving Surgeries

Document Type : Original Article

Authors

1 Department of General Surgery, Faculty of Medicine, Ain Shams University, Egypt

2 Department of General Surgery, Faculty of Medicine, New Giza University, Egypt

Abstract

Background: The breast cancer is the most common malignancy in Egyptian women. The management of breast
cancer evolves with time. The breast conserving Surgery (BCS) thereby, is now the gold standard when managing
cases with early breast cancer, it is composed of BCS and adjuvant radio therapy. However, managing cases with
locally advanced breast cancer is more challenging.
Patients and methods: This was a concurrent cohort study, conducted in Ain Shams University Hospitals,
between June 2017 to June 2021. Patients were with age ranging from 20 and 60 years. Patients were suffering
of malignant breast masses, which is either T1-3, near to the skin, with no skin involvement, or a previously T4b
mass and the patient received neo-adjuvant therapy with complete clinical resolution of the skin; T3 masses should
have received neoadjuvant therapy and had a good response, and patients were accepting the procedure. Patients
with the following criteria were excluded: presence of residual skin involvement after the neoadjuvant therapy or
inflammatory breast cancer, multicentric breast cancer, those with history of BCS on the same side, patients with
contraindications or refusing postoperative radio therapy or heavy smokers. Patients (n=31) underwent dermoglandular
or dermo-muscular flaps with skin islands after BCS and limited skin excision.
Results: The mean age was 43.8±6.4, the mean BMI was 35±5.6 kg/m2. The most prevalent cup size was D
(35.5%). The breast masses had a mean size of 3.5±1.1 cm. Early post operative complications were reported in
16.1% (n=5) of the patients. The most recorded complication was wound dehiscence 12.9% of the patients, a
single patient suffered of wound hematoma. No recoded cases of wound infection or flap necrosis among the study
group. Seroma was recorded in 9 (29%) patients. No local recurrences were reported. The esthetic results were
Good in 81%, Fair in 13% and Poor in 6%.
Conclusion: The DGF and DMF with skin islands are feasible, safe, with good esthetic results for the repair of the
skin defects resulting from skin excision during the breast conserving surgeries.

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