Clinical effects of superior epigastric artery perforator fascial flaps in repairing huge chest wall wounds after breast tumor surgery

Yuan Ying; Zhou Min; Qi Baiwen; Yu Aixi; Jian Chao; Wu Yifan

doi:10.3760/cma.j.cn501225-20240930-00367

Volume 41 Issue 9

Sep. 2025

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Article Navigation > CHINESE JOURNAL OF BURNS AND WOUNDS > 2025 > 41(9): 895-901

Yuan Y,Zhou M,Qi BW,et al.Clinical effects of superior epigastric artery perforator fascial flaps in repairing huge chest wall wounds after breast tumor surgery[J].Chin J Burns Wounds,2025,41(9):895-901.DOI: 10.3760/cma.j.cn501225-20240930-00367.

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Clinical effects of superior epigastric artery perforator fascial flaps in repairing huge chest wall wounds after breast tumor surgery

doi: 10.3760/cma.j.cn501225-20240930-00367

Department of Orthopedics Trauma and Microsurgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China

Funds:

Science and Technology Department of Hubei Province Jiebang Project 2022BEC028

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Corresponding author: Wu Yifan, Email: 2013302180035@whu.edu.cn
Received Date: 2024-09-30

Abstract

Abstract

Objective To investigate the clinical effects of superior epigastric artery perforator fascial flaps in repairing huge chest wall wounds after breast tumor surgery. Methods This study was a retrospective observational research. From July 2018 to June 2024, 8 patients with breast tumor were admitted to Zhongnan Hospital of Wuhan University. The areas of skin and soft tissue defects of chest wall caused by extended resection of tumor reached 20 cm×18 cm to 24 cm×20 cm, and all of them were repaired by superior epigastric artery perforator fascial flaps. The flaps were excised along the surface of the rectus abrectus muscle on the same side of the chest wall defects, with the harvested flap area of 20 cm×8 cm to 18 cm×10 cm. The inferior abdominal vessels and their large perforators were retained at the distal end of the flaps. The inferior abdominal wall vessels at the distal end of the flaps were anastomosed with the internal thoracic vascular branches in the recipient areas in 4 patients, while no vessels were anastomosed in the other 4 patients. The wounds in the donor areas were sutured directly in all patients. The survival of the flaps, and the healing of the wounds and the occurrence of complications in the donor and recipient areas were observed after the operation. Postoperative follow-up was conducted to observe the thoracic tumor recurrence, the flap appearance, and the occurrence of complications in the donor area. Results The flaps in all patients survived well, without occurrence of vascular crisis. The scattered ecchymosis appeared at the distal end of the flaps in two patients after surgery, which did not progress to flap necrosis after symptomatic and supportive treatment, and the ecchymosis subsided within 4 weeks after surgery. All the wounds in the donor and recipient areas healed without complications. The follow-up for 3 to 6 months showed no local recurrence of the tumor, satisfactory appearance of the flap, mild linear scar hyperplasia left in the donor area, and no abdominal hernia or abdominal wall weakness. Conclusions The superior abdominal artery perforator fascial flap is simple in resection operation, has a high survival rate, causes less damage to the donor area, and can effectively repair the huge skin and soft tissue defect wounds of the chest wall after operation of breast tumor.
- Microsurgery,
- Breast neoplasms,
- Thoracic wall,
- Perforator flap,
- Fascial flap,
- Superior epigastric artery perforator,
- Wound repair

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References(40)

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