Safety of long-term subcutaneous free flap skin banking after skin-sparing mastectomy

Abstract

BackgroundA persistent problem in autologous breast reconstruction in skin-sparing mastectomies is skin restoration after skin necrosis or secondary oncological resection. As a solution to facilitate reconstruction, skin banking of free-flap skin has been proposed in cases where the overlying skin envelope must be resected, as this technique spares the patient an additional donor site. Herein, we present the largest series to date in which this method was used. We investigated its safety and the possibility of skin banking for prolonged periods of time.MethodsAll skin-sparing mastectomies and immediate autologous breast reconstructions from December 2009 until June 2013 at our institution were analysed.ResultsWe identified 31 patients who underwent 33 free flap reconstructions in which skin banking was performed. Our median skin banking period was 7 days, with a maximum duration of 171 days. In 22.5% of cases, the banked skin was used to reconstruct overlying skin defects, and in 9.6% of cases to reconstruct the nipple-areolar complex. Microbiological and histological investigations of the banked skin revealed neither clinical infections nor malignancies.ConclusionsIn situ skin banking, even for prolonged periods of time, is a safe and cost-effective method to ensure that skin defects due to necrosis or secondary oncological resection can be easily reconstructed.

Skin For Life: Skin Donation And Skin Banking

“…the uppermost layer of the skin is harvested. 30 In this procedure, there is no bleeding from the site where the skin is harvested from and there is no disfigurement to the body also. After the procedure, the team bandage the parts from where the skin is removed in a proper way.…”

Salvage of Mastectomy Flap Necrosis by Skin Graft Harvested from Contralateral Breast

“…Several studies have reported on salvage methods for cases in which mastectomy flap necrosis develops following immediate breast reconstruction. Verstappen et al 3 attempted in situ skin banking during immediate autologous breast reconstruction after skin-sparing mastectomy, using the former when necrosis developed. If necrosis did not develop, their plan was to remove this under local anesthesia around 7 days after the surgery; infections and other complications were not found to be reported.…”