Sie Thu Myint^1,2*, Aung Myat¹, Htun Thuya¹ and Thein Lwin¹

¹Department of Surgery, University of Medicine (1), Yangon, Myanmar
²Surgical Ward 2, Yangon General Hospital, Myanmar

*Corresponding Author: Sie Thu Myint, Department of Surgery, University of Medicine (1), Yangon, Myanmar.

Received: September 27, 2022; Published: October 28, 2022

Abstract

Introduction: Locally advanced breast cancer is common in Yangon General Hospital and constitutes about 25.5% of breast cancer cases. For the local control and quality of life, mastectomy is needed in the form of extensive surgery. Extensive mastectomy, toilet mastectomy, results in large skin defect which needs proper closure.

Aim: The aim of this study is to find out the various ways of defect closure after extensive surgery for the locally advanced breast cancer.

Method: Forty-one patients from 1^st Jan 2018 to 31^st December 2019 were included in this descriptive study. Clinical profiles were recorded. The types of closure of the skin defect were recorded. Postop complications were recorded.

Results: There are 181 breast cancer patients who underwent mastectomy and axillary dissection in surgical ward 2 of Yangon General Hospital. Forty-one patients (22.7%) had locally advanced breast cancer. In 37 patients, the defects were closed with bilateral advancement flap. Four patients (10.8%) developed flap necrosis in bilateral advancement flap. Three patient developed wound sepsis (8.1%). Six patients (16.2%) developed wound gaping. One patient underwent thoraco-epigastric flap. That patient develops wound sepsis. That patient has history of application of traditional medicine and has infected skin ulcer over the breast mas. Her culture result is moderate growth of enterococci. One patient underwent split skin graft. Two patients underwent thoraco-abdominal flap.

Conclusion: Bilateral advancement flap is a straight-forward way of closing the defect after extensive mastectomy. This type of closure is most used to get early closure. Thoraco-abdominal flap and split skin graft are also useful technique. Each method has its own advantages and disadvantages. Surgeon should tailor the surgery to the patient.

Keywords: Breast Cancer; Yangon General Hospital; Mastectomy

Bibliography

1. Annual Statistical Report. Yangon General Hospital (2017).
2. “Estimated cancer incidence, mortality and prevalence worldwide” (2020).
3. Lee MC and Newman LA. “Management of patients with locally advanced breast cancer”. Surgical Clinics of North America 87 (2007): 379-398.
4. Leinster SJ and Webster DJ. “Thoraco-abdominal and thoraco-epigastric flaps: alternatives to skin grafting after mastectomy”. Clinical Oncology 8 (1982): 145-148.
5. Joo Seok Park., et al. “Using Local Flaps in a Chest Wall Reconstruction after Mastectomy for Locally Advanced Breast Cancer”. Archives of Plastic Surgery3 (2015): 288-294.

Citation: Sie Thu Myint., et al. “Closure of Skin Defect After Mastectomy for Locally Advanced Breast Cancer". Acta Scientific Clinical Case Reports 3.11 (2022): 13-16.

Copyright: © 2022 Sie Thu Myint., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.