PDF herunterladen
Open Access
CC BY-NC-ND 4.0 · Indian J Plast Surg 2024; 57(S 01): S73-S79
DOI: 10.1055/s-0044-1788571
Original Article

Medially Based “Abdominal Rotation Advancement Flap”: A Promising Technique for Mastectomy Defect Reconstruction in “High-Risk Patients” Awaiting Adjuvant Radiotherapy

Autoren

  • Praveen Harish

    1   Department of Plastic Surgery, MNJ Institute of Oncology and Regional Cancer Centre, Hyderabad, Telangana, India

  • Kathi Srinath

    1   Department of Plastic Surgery, MNJ Institute of Oncology and Regional Cancer Centre, Hyderabad, Telangana, India

  • Swamy Vivek

    1   Department of Plastic Surgery, MNJ Institute of Oncology and Regional Cancer Centre, Hyderabad, Telangana, India

  • Santosh Kumar Gandupalli 

    2   Department of Plastic Surgery, Osmania Medical College, Telangana, India

  • Yogesh Kadam

    2   Department of Plastic Surgery, Osmania Medical College, Telangana, India

  • G. Kavya

    2   Department of Plastic Surgery, Osmania Medical College, Telangana, India

Funding None.
Weitere Informationen
Auch verfügbar auf
  Lizenzen und Reprints

Abstract

Background Extensive postmastectomy defects and soft-tissue defects often require some additional flap cover of reconstruction after excision. The reconstruction aim in this group should be a diligent and easy closure with a quality skin cover, early recovery, and brief stay in hospital so that the patients can receive early postoperative radiotherapy/chemotherapy. Medially based abdominal transposition flap is a type C fasciocutaneous flap based on medial perforating vessels. We present our experience in significant postmastectomy defects, especially in high-risk morbid patients.

Materials and Methods This is a retrospective study conducted by the department of plastic surgery, from an analysis of the breast cancer database maintained by our hospital from 2019 to 2023. A total of 826 breast cancer patients underwent surgery, of which 547 were locally advanced breast cancer (LABC) patients and 138 (32.5%) LABC patients needed flap cover for mastectomy defect. Medially based abdominal transposition flap was used in 56 of 138 (40.5%) LABC patients for defect closure, and 42 of the 56 patients were stage IIIB patients. Upfront surgery was primarily done in 20 patients and 36 patients underwent surgery after neoadjuvant chemotherapy. This analysis aimed to assess the operative duration, postoperative morbidity, hospital stay, and time taken to start adjuvant treatment by analyzing the medical records of patients who underwent this procedure.

Results Fifty-six patients with breast cancer underwent surgical intervention, whereby 8 patients presented with tip and edge necrosis, and 3 patients were infected. The mean duration of operation was 58.852 minutes, and the average length of hospital stay was 5.39 days. It took 24.57 days for the patients to stabilize sufficiently for adjuvant therapy. The average age of the patients in the study was 48.73 years.

Conclusion Our clinical experience has demonstrated that the medial abdominal transposition fasciocutaneous (MATF) flap represents a straightforward, reliable, and cost-effective method for managing extensive postmastectomy soft-tissue defects in a subset of patients with LABC. This group typically consists of high-risk and comorbid patients. The procedure holds considerable promise for developing countries with limited infrastructure and expertise, owing to its ease of execution and short learning curve. By its simplicity and affordability, the MATF flap offers a viable and sustainable solution for treating LABC-associated soft-tissue defects.

Keywords

medially based abdominal transposition flap - postmastectomy defects - locally advanced breast cancer


Publikationsverlauf

Artikel online veröffentlicht:
03. September 2024

© 2024. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India