International Journal of Collaborative Research on Internal Medicine & Public Health

“Thoraco-Abdominal Flap”- A Simple Flap for Skin and Soft Tissue Cover Following Radical Surgery for Locally Advance Breast Cancer-The Malaysian Experience

Backgrounds: Locally advance breast cancer (LABC) is a major concern for clinicians due to its large numbers and its complex treatment. Skin and soft tissue cover after radical breast surgery is one of the most challenging issues.

Aim & Objectives: To evaluate the efficacy of thoraco- abdominal flap (TA) in terms of convenience, patient compliance and tolerability to adjuvant radical radiotherapy in operable LABC patients in which primary skin cover was not possible due to large post operative skin and soft tissue defects.

Methods: A prospective analysis of twenty patients with LABC, who underwent mastectomy and axillary clearance over a period of eighteen months were included in this study. Primary skin closure was not possible for any of these patients due to large skin and soft tissue defect produced after radical surgery. All of them were subjected to TA flap to cover the skin gap produced after surgery. Immediate postoperative outcomes, tolerability to postoperative radiotherapy (PORT) were analyzed.

Results: Out of these twenty patients, one patient (5%) had minor wound break down in the immediate post operative period which was managed by dressing and secondary suturing under local anesthesia. Rest all nineteen patients were discharged from hospital without any complications within the expected discharge time period (3-4 days). All of them tolerated PORT well. None of them showed any loco-regional or distal recurrence in 18 months follow up period.

Conclusions: In view of its simplicity, low cost, good postoperative compliance and well tolerability to PORT, it can be concluded that TA flap can be the first choice in LABC patients requiring skin and soft tissue cover after radical surgery.

Author(s):

D.K Das , UC Choudhury

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