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The Thoracoepigastric Flap for Chest Wall Coverage
Naveed Nosrati MD, Tyler A. Evans MD, Michael Chu MD, Rajiv Sood MD, Juan Socas MD
Indiana University
2016-02-01
Presenter: Tyler A. Evans
Affidavit:
This is original work by all authors involved including residents and attendings.
Director Name: Rajiv Sood
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Introduction: Late stage and locally aggressive breast cancer are an uncommon diagnosis as surveillance and awareness has improved. These malignancies frequently undergo neoadjuvant radiotherapy and require wide resections that can prevent the use of implant-based reconstruction. These patients also often have multiple comorbidities and unknown prognosis; therefore complex reconstruction and lengthy procedures are not indicated. If there are exposed critical structures a skin graft is a lesser option for coverage. The thoracoepigastric flap is an adipocutaneous flap that can be used for chest wall reconstruction in these patients with a poor prognosis, and is a safe, efficient, and reliable option.
Methods: A retrospective analysis was performed of all consecutive patients that had breast reconstruction for mastectomy from 2012 to 2015. Patients that had a thoracoepigastric flap were identified as the cohort. Patient demographics, cancer stage, perioperative details, radiation therapy, complications, length of follow-up, and outcomes were analyzed.
Results: A total of nine patients were identified, (Table 1). There were no major complications; two patients developed axillary contractures, and three patients died from progression of metastatic disease within a year of surgery.
Conclusions: The thoracoepigastric flap can provide quick and reliable chest wall coverage in the subset of patients with advanced stage cancer, poor health, and unknown prognosis.
