Radical mastectomy: thick vs thin skin flaps

Radical mastectomy with wide skin excision, ultrathin skin flaps, and autogenous skin grafts was a selected treatment of 45 women with curable breast cancer. A similar group of 45 women were treated by radical mastectomy with less wide skin excision, primary wound closure, and without ultrathin skin flaps. The two patient series were comparable in clinical disease staging, age, axillary node metastases, and frequency of adjunctive chest-wall irradiation. Retrospective chart reviews of the two patient series and statistical analyses indicated that five-and ten-year survival and local recurrences were comparable, but wound complications, hospital stays, and subsequent lymphedema were significantly greater in the series with thinner skin flaps. We recommend that routine use of ultrathin flaps be abandoned for treatment of breast cancer.