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Cirugía Plástica Ibero-Latinoamericana

On-line version ISSN 1989-2055Print version ISSN 0376-7892

Abstract

MORETTI, Ernesto A; CAMARGO, Jonathan; SETTECASI, Julieta  and  FALZONE, Selene. Experience with thoracoabdominal flaps in breast reconstruction. Personal classification and variants. Cir. plást. iberolatinoam. [online]. 2020, vol.46, n.4, pp.401-410.  Epub Feb 08, 2021. ISSN 1989-2055.  https://dx.doi.org/10.4321/s0376-78922020000500004.

Background and objective.

The thoracoabdominal flap allows the closure of thoracic defects with a lower morbidity and technical difficulty compared to remote flaps. In mammary oncological reconstructive surgery, they were primarily used as fasciocutaneous flaps for patients with locally advanced breast cancer (T3 and T4) that require large skin resections and a fast and effective coverage of the thoracic defect. In recent years they have resurged as a therapeutic option to solve postoperative complications due to ischemia and skin necrosis with exposure of expanders or breast implants.The increase in the practice of risk-reducing mastectomy has led to areas of small skin necrosis that require local flaps to solve the complication. It is in this last indication where these flaps have an optimal application.

Methods.

In this study, the thoracoabdominal flap is presented as a very useful reconstructive technique to cover skin defects in breast surgery. A classification is presented in order to clarify these fasciocutaneous flaps as well as our experience with theme.

Results.

We elaborate a didactic classification of thoracoabdominal flaps, presenting a clinical case of each flap model, and compiling our casuistry.

Conclusions.

We highlight the specific use in complications of breast reconstruction surgeries of thoracoabdominal flaps as an alternative that provides tissues of the same color, easy to perform, with direct closure of the donor area and with a reliable vascular pedicle. In addition, we provide our own classification

Keywords : Thoracoabdominal flap; Thoracoepigastric flap; Breast reconstruction.

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