Dermal sling used in the management of breast cancer in Egyptian women with large breasts

Abstract

Introduction Large breast sizes are prevalent among Egyptian women. When breast reconstruction is performed in these patients, it is difficult and unsafe. Wound dehiscence leads to the risk of implant exposure. Acellular dermal matrices are expensive and infections occur. Aim To evaluate the safety and efficacy of the use of inferior–lateral dermal flaps to create complete pocket coverage of implants and expanders together with the pectoral muscles. Patients and methods Thirty patients with breast cancer underwent skin-reducing mastectomies and prostheses using the dermal slings were evaluated for technical issues and rates of postoperative complications. Results Early postoperative complications occurred in four patients in the form of wound dehiscence, nipple necrosis, and persistent drainage of serum for more than 2 weeks. Cases with wound dehiscence were managed by operative debridement of the edges and re-closure. Nipple loss occurred in one case; in this patient, we deflated the expander, removed the areola, and closed the gap. Cases with persistent drainage were treated conservatively. No exposure was encountered even in complicated cases. Conclusion Dermal slings enabled the creation of complete pocket coverage for implants and expanders, with a low complication rate. The procedure is safe and reliable. It is suitable for our patients with large breasts and major ptosis.