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Utility of External Oblique Myocutaneous Flaps in massive skin defects post Mastectomy

Mr. UTSAB MAN SHRESTHA

Introduction:

Reconstruction of large skin defects following Mastectomy remains a technical challenge for Oncosurgeon and Plastic Surgeon alike, while skin grafts are non-aesthetic , other local fascio-cutaneous and pedicled flaps are often inadequate for full coverage. While free flaps are increasingly used for aesthetic breast reconstruction they often require expertise, equipment and time that are not frequently available in a setting like ours. Since a large cohort of Breast cancer patients often present in late stage with skin involvement; operability and outcome are often determined by whether negative margins could be achieved with satisfactory soft tissue reconstruction. As of late, we have used External Oblique Myocutaneous (EOM). Flap as means of closing such large defects with encouraging results.

Material and Methods:

Between April 2015 to August 2019,5patients who had mastectomy with skin defect larger than 15cms underwent EOM flap procedure at Bhaktapur Cancer Hospital. All surgeries were conducted by the same team surgeons.

Result:

Total of 5 patients were taken up for the surgery. The diagnoses were Ca. Breast, Glant Cystosarooma Phyllolides, Fungating Ca Breast. The defect sizes were 19 x 25 cm, 20 x 22cm and 22x24cm. There were only minor complication in the post operative period.

Conclusion:

Although infrequently used, external oblique Muscle flap is a useful adjuct in patient undergoing mastectomy with massive skin void.

Keyword:

External oblique, carcinoma breast, massive defects

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