Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Safety of long-term subcutaneous free flap skin banking after skin-sparing mastectomy

  • Verstappen, Ralph (Department of Hand, Plastic and Reconstructive Surgery, St. Gallen Cantonal Hospital) ;
  • Djedovic, Gabriel (Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University) ;
  • Morandi, Evi Maria (Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University) ;
  • Heiser, Dietmar (Department of Dermatology, Innsbruck Medical University) ;
  • Rieger, Ulrich Michael (Department of Plastic and Aesthetic, Reconstructive and Hand Surgery, Agaplesion Markus Hospital, Johann Wolfgang von Goethe University) ;
  • Bauer, Thomas (Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University)
  • Received : 2017.08.07
  • Accepted : 2018.01.09
  • Published : 2018.03.15
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Abstract

Background A persistent problem in autologous breast reconstruction in skin-sparing mastectomies is skin restoration after skin necrosis or secondary oncological resection. As a solution to facilitate reconstruction, skin banking of free-flap skin has been proposed in cases where the overlying skin envelope must be resected, as this technique spares the patient an additional donor site. Herein, we present the largest series to date in which this method was used. We investigated its safety and the possibility of skin banking for prolonged periods of time. Methods All skin-sparing mastectomies and immediate autologous breast reconstructions from December 2009 until June 2013 at our institution were analysed. Results We identified 31 patients who underwent 33 free flap reconstructions in which skin banking was performed. Our median skin banking period was 7 days, with a maximum duration of 171 days. In 22.5% of cases, the banked skin was used to reconstruct overlying skin defects, and in 9.6% of cases to reconstruct the nipple-areolar complex. Microbiological and histological investigations of the banked skin revealed neither clinical infections nor malignancies. Conclusions In situ skin banking, even for prolonged periods of time, is a safe and cost-effective method to ensure that skin defects due to necrosis or secondary oncological resection can be easily reconstructed.

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References

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