Arch Plast Surg.  2018 Mar;45(2):146-151. 10.5999/aps.2017.01382.

Safety of long-term subcutaneous free flap skin banking after skin-sparing mastectomy

• Verstappen R
• Djedovic G
• Morandi EM
• Heiser D
• Rieger UM
• Bauer T

• KMID: 2409459
• DOI: http://doi.org/10.5999/aps.2017.01382

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.

Keyword

Reconstructive surgical procedures; Mammaplasty; Free tissue flaps; Breast neoplasms; Transplantation, autologous

MeSH Terms

Breast Neoplasms
Female
Free Tissue Flaps*
Humans
Mammaplasty
Mastectomy*
Methods
Necrosis
Reconstructive Surgical Procedures
Skin*
Tissue Donors
Transplantation, Autologous