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Skin Graft to cover a Skin Breast Necrosis

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Skin graft is one of the most indispensable techniques in surgery and are used in a variety of clinical situations, such as traumatic wounds, defects after oncologic resection or burn reconstruction. Skin grafts are generally classified as split-thickness or full-thickness grafts. When a graft includes only a portion of the dermis, it is called a split-thickness skin graft. When a graft contains the entire dermis, it is called a full-thickness skin graft. Split-thickness skin grafts are further classified into mesh skin grafts, stamp skin grafts, and chip skin grafts, based on their shape.

With consideration of aesthetic results, the donor site should be similar to the recipient site in terms of consistency, thickness, color, and texture.  To cover a breast defect, in which maximum care must be taken, full-thickness skin grafts are often needed. Common donor site for full-thickness skin grafts of the breast include the abdominal region by its similarity to the mammary skin and because the donor site can be primarily sutured. Also, the scar of the donor site can be hidden in the under wear.

This 78-year-old woman presents a skin necrosis after a bilateral abdominal flap due to a cutaneous recurrence.
An abdominal skin graft with a size and shape similar to the chest wall defect was performed.
The skin graft presented a good evolution during the postoperative period and allowed the irradiation of the chest wall with a good tolerance of the skin graft

Next video shows, step by step, the use of a skin graft to cover a skin necrosis in a woman with breast reconstruction. Prior to surgery, a VAC system was used to improve local conditions in the recipient site.

This 56-year-old patient presented irradiated skin necrosis from her mastectomy after reconstruction with a latissimus dorsi flap.
A VAC system was placed to improve the conditions of the recipient site
An abdominal skin graft with a size and shape similar to the skin defect was performed.

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