A New Skin Graft Donor Site Using the Abdominal Dog-Ear Deformity in Mastectomy Flap Necrosis

ABSTRACT

BACKGROUND: Mastectomy flap necrosis is a common complication after mastectomy and immediate reconstruction with a deep inferior epigastric perforator (DIEP) flap. After abdominal free flap breast reconstruction, the most common secondary procedure is dog-ear correction of both flanks. We introduce a treatment for skin necrosis with a full-thickness skin graft (FTSG) using the abdominal dog-ear deformity. METHODS: In patients with skin necrosis of a mastectomy flap, we debrided all necrotic tissue when the demarcation was complete. We then performed an FTSG using the skin from the dog-ear correction of both flank areas. We fixed the graft with a tie-over dressing, and it was then removed on postoperative day 5. RESULTS: Skin necrosis of the mastectomy flap and dog-ear deformity were treated without any complications. The color and texture of the breasts were satisfactory. CONCLUSIONS: If a patient experiences post-mastectomy skin flap necrosis and has a dog-ear deformity on both sides of the flank after a DIEP flap, a dog-ear skin flap can be a good alternative donor site for reconstruction.