Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 2019 , Vol 10, Issue 3
A Clinical Experience With Closure of The Donor Site Following Lower Abdominal Wall Flap With Dermal Recycling Graft
Semih Bağhaki1
1İstanbul Üniversitesi, Cerrahpaşa Tıp Fakültesi, Plastik, Rekonstrüktif ve Estetik Cerrahi Anabilim Dalı, İstanbul, Türkiye DOI : 10.31067/0.2019.172 Introduction: From pedicled TRAM flap to perforator based DIEP flap, all lower abdominal flaps cause varying degrees of abdominal wall morbidity. The results of a case series, where dermal graft produced from less perfused portions of these flaps in order to enhance fascial closure, have been presented.

Method: Retrospective chart review of 33 patients who underwent breast reconstruction between September 2012 and August 2016 has been performed. Demographic data, photographic documentation, operative notes, follow up visit notes and subjective evaluations of the patients in the long term have been gathered.

Results: The age of the patients ranged between 35 and 56 with an average of 43. Twenty-two of the patients were premenopausal and 11 were postmenopausal. The BMI of the patients ranged between 26,2 and 34,6 with an average of 28,8. Fourteen of the patients underwent immediate breast reconstruction and 19 of the patients underwent delayed breast reconstruction. Twentyone pedicled TRAM flaps, 5 free TRAM flaps, 4 free muscle-sparing TRAM flaps and 3 DIEP flaps have been performed. The followup period ranged between one year and three years with an average of 15 months. None of the patients experienced hernia formation in the follow-up period. In 2 patients, bulging of the donor area has been observed and in one of these two patients the fascial repair was performed. No infection or foreign body reaction has been observed in any of the patients. All of the patients reported normal active trunk flexion during daily activities.

Conclusion: The dermal "recycling" graft produced from poorly perfused parts of lower abdominal flaps yields satisfactory results with practical ease. Keywords : Dermal, graft, breast reconstruction