Perforator flaps in the reconstruction of Breast and thorax burnts

Liliana Scarpinelli

Oncological, traumatic and burn sequelae in the chest and breasts are problematic. The growth of tissues and sexual maturity, on scarred areas, produces glandular alterations, with the appearance of deforming skin bridles and contractures. Reconstructive surgery provides solutions to avoid deformities using neighbor perforator flaps. Eight patients (8-23 years) with severe sequelae in the thorax and breasts underwent surgery under general anesthesia using magnifying devices. Rhomboid design skin flaps and adipose tissue with a major axis interposed in the affected area were used. The arterial perforating vessel, centrally located, was rotated like a “helix” to reach a greater distance. Surgeries lasted 3 h and patients were hospitalized for other 24 h. We observed an average elongation of 5-7 cm in scars after surgery. All patients used for a year, compression elastic meshes. With this approach interposing healthy skin, an adequate development of the mammary region was achieved obtaining long lasting results with less morbidity, and faster recovery than traditional techniques. The complications were minor: partial dehiscences in the distal end. As a disadvantage, the skin of the armpit changed the hair orientation. In conclusion, we observed an improvement in the mammary tissue recovery in patients and greater mobility of the upper limbs using skin from healthy regions. In partial mastectomies this technique allows to reconstruct lateral defects, with stable long-term results.