Mastectomy skin flap necrosis: challenges and solutions

Area of Science:

• Oncology
• Plastic Surgery
• Wound Healing

Background:

• Mastectomy skin flap necrosis (MSFN) occurs in 5%-30% of cases, presenting a significant clinical challenge.
• MSFN can manifest as partial or full-thickness necrosis, leading to complications like delayed adjuvant therapy and aesthetic compromise.

Purpose of the Study:

• To review the challenges associated with mastectomy skin flap necrosis.
• To discuss potential solutions and management options for MSFN.

Main Methods:

• A comprehensive literature search was conducted using "mastectomy skin flap necrosis" on MEDLINE.
• Titles and abstracts of peer-reviewed publications were screened for relevance to identify key findings.

Main Results:

• Predictive risk factors for MSFN include smoking, diabetes, obesity, radiotherapy, and comorbidities.
• Meticulous surgical technique and preoperative planning can reduce MSFN incidence.
• Management options include operative and nonoperative approaches, with early intervention potentially reducing morbidity.

Conclusions:

• MSFN poses considerable challenges for both patients and healthcare systems.
• Effective management strategies are crucial for mitigating the impact of MSFN.
• Further research is needed, particularly on interventions like topical nitroglycerin.