Use of reverse abdominal fascio-cutaneous flap in reconstruction of large chest wall defect after mastectomy owing to malign tumor

Abstract

Defects resulting from resection of advanced breast cancers can be quite large, posing a difficult reconstructive challenge. Lots of patients are presented with local recurrences after radiotherapy and/or chemotherapy treatments. Abdominal fascio-cutaneous flap, pectoralis, latissimus dorsi, rectus abdominis and omentum pedicled flaps or free flaps may be used for reconstruction of the chest wall. The described rotation flap extends from the posterior axillary line to linca alba and inferior line is determined like abdominoplasty. We preferred this flap, which is safe, reliable and leaves minimal donor morbidity, particularly in patients with late stage tumors. The technique was used on 11 female patients with major chest-wall defects after mastectomy between 1999 and 2001. Chest wall defects after resection varied between 9 x 11 and 12 x 15cm (vertical x horizontal). Marginal skin necrosis of about 1 x 2cm was observed in one patient but didn't require any correction. In our opinion, this technique is a viable alternative in repairing large defects in the anterior chest wall.