Reply: ITADE flap after mastectomy for locally advanced breast cancer: A good choice for mid‐sized defects of the chest wall based on a systematic review of thoracoabdominal flaps

VRAM flap for locally advanced breast cancer

“…In choosing the flap to close the defect after mastectomy, several factors were involved: the surgeon's experience, the size of the defect, training in microsurgical techniques, and the potential complications involved. In general, the microsurgical and myocutaneous flaps allow the closure of areas superior to the fasciocutaneous or dermo-fat flaps, except for the ipsilateral thoracoabdominal dermofat (ITADE) flap, which, despite covering an extensive area, is associated with a higher rate of complication and cutaneous necrosis, being the necrosis greater than 4.3% and smaller than 34.7% 6,8,9 . It is known that few services have professionals qualified in microsurgical techniques, and the breast surgeon must have knowledge of the different reconstruction possibilities and their strengths and weaknesses, allowing the best choice of the myocutaneous flaps to be used.…”

Surgical management of locally advanced breast cancer: Recommendations of the Brazilian Society of Surgical Oncology

“…Lateral flaps have a lower rate of necrosis. 32,45 Thoracoabdominal flaps are described in case series, are easy to perform, do not require the involvement of reconstructive surgeons, and have a higher rate of necrosis than myocutaneous flaps, with variations in the complication rate according to the type of flap. 32 Table 1 reviews previous group publications 32,33 and updated literature 32,33,43,46,[48][49][50][51][52][53] related to the use of flaps for breast cancer treatment or VRAM (vertical rectus abdominis myocutaneous) flaps in oncologic procedures.…”

“…Their main advantage is the ease of use, but they may be associated with a higher rate of necrosis than myocutaneous flaps. Lateral flaps have a lower rate of necrosis 32,45 …”

“…Historically, these flaps were classified as dermofat and fasciocutaneous flaps, 32 but this classification has been revised. 45 These flaps are used to close small and medium defects. Their main advantage is the ease of use, but they may be associated with a higher rate of necrosis than myocutaneous flaps.…”

“…Historically, these flaps were classified as dermofat and fasciocutaneous flaps, 32 but this classification has been revised 45 . These flaps are used to close small and medium defects.…”