title: Extended deepithelialization to secure double-breasted closure of the skin.
abstract: Double-breasted closure of the skin is achieved by deepithelialization of 1 edge of a wound and advancement of the opposite edge over this deepithelialized area. Such closure may prevent contamination or exposure of the implant in cases where immediate breast reconstruction with prosthetic material is obtained after skin sparing mastectomy. The deepithelialization routinely extends as far as the incision to be closed and, consequently, the skin suture at the end of the incision immediately overlies thedeep suture or implant in cases where the implant is not fully covered by muscle. To prevent contamination or exposure of the implant when suture infection or wound dehiscence occurs in these cases, we extend the deepithelialization beyond and around the limit of the skin incision. This allows for complete and secured double-breasted closure of the entire wound and lessens the risk of implant contamination or exposure.
authors.affiliation: Department of Plastic and Reconstructive Surgery at the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
authors.forename: Leonie A E
authors.initials: LA
authors.lastname: Woerdeman
authors.forename: J Joris
authors.initials: JJ
authors.lastname: Hage
authors.forename: Arjen A W M
authors.initials: AA
authors.lastname: van Turnhout
mesh_terms: D018427:Breast Implants; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D042361:Mammary Glands, Human / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control