Usefulness of Thoracoepigastric (TE) Flap as Part of Surgical Treatment for Locally Advanced Breast Cancer in the Elderly

Abstract

In our hospital, artificial dermis (PELNAC G plus^®) was used at the time of initial surgery for patients with high-risk locally advanced breast cancer who did not wish to undergo breast reconstruction and were elderly, diabetic, or had complications from infection. After confirming negative margins, we performed two-stage meshed full-thickness skin grafting. In all five cases with artificial dermis, the all-layer grafts grew well. However, one of the three patients who underwent postoperative radiotherapy developed a refractory ulcer after radiotherapy, which was difficult to treat. Therefore, we changed the flap to a thoracoepigastric (TE) flap, which is a rotational skin valve that moves the abdominal skin to the skin defect. We have now reported two cases of thoracic wall reconstruction using the TE flap. Since the postoperative course was uneventful and early postoperative irradiation could be performed safely, we report on the usefulness of this technique.