N. Srinivasa Rao1, S. Mythili Devi2, K. Babji3
Covering of large wounds after mastectomy in locally advanced Ca breast with skin that can withstand radiotherapy is a challenge to the surgeon. Here this study we used a local advancement flap from the adjacent area called Thoraco-Abdominal Flap (TA flap) for such giant defects. This is based on superficial and lumbar arteries and is thick to with stand consequent RT
MATERIALS AND METHODS: Of the total 107 cases of LABC 32 had post mastectomy defects of larger than 12 cm and could not be closed by simple approximation. Among the 32 cases 17 cases are covered by split thickness skin grafting. 15 cases are covered by TA flap. These cases are assessed for mean operating time, mean blood loss, post-operative stay, flap necrosis and viability of the flap after radiotherapy.
RESULTS: There is minimal extra time or blood loss in these cases. All the flaps healed well except for small edge necrosis in 4 cases. In all the patients we could start radiotherapy in the fourth week of surgery and all the flaps withstood RT well. After further evaluation probably this can be recommended as procedure for giant post mastectomy defects particularly for those who require RT early
