title: Dermal flaps in breast reduction: prospective study in 100 breasts.
abstract: The most common complication of breast reduction with inverted T-scar technique is wound dehiscence at the junction of the vertical and horizontal sutures. In this study, a technique involving three triangular dermal flaps is presented with the results for healing in the junctional T zone. Fifty women were included in a comparative, single-center randomized double-blind prospective study to evaluate the efficiency of the three-triangular dermal-flap technique in healing in the junctional T zone. All patients were seen for follow-up at 7 days, 14 days, 21 days, 28 days, 35 days, 42 days, and 49 days after surgery to evaluate primary healing in the T zone. Average healing time was 19.7 days in the triangular-skin-flap series and 25.48 days in the control series, with a statistically significant difference (p < 0.01). One patient in the triangular-skin-flap series experienced dehiscence in the T zone (2%) versus eight patients (16%) in the control series. A statistically significant difference was noted (p = 0.012). This technique is based on the association of two principles. First, ischemia on the edges as well as skin necrosis is limited by suturing the two superior skin flaps rather than directly suturing the cutaneous angles. In addition, this technique brings an underlying dermal support. Second, the inferior flap width allows fixing two sutures laterally to limit the central tension. This easy technique does not lengthen total operative time and significantly improves healing time. It is applicable to all breast reductions with inverted T scars.
authors.affiliation: Oral, Maxillo-facial and Plastic Surgery Department, Gui De Chauliac University Hospital, Montpellier, France. Electronic address: s-domergue@chu-montpellier.fr.
authors.forename: Sophie
authors.initials: S
authors.lastname: Domergue
authors.affiliation: Oral, Maxillo-facial and Plastic Surgery Department, Gui De Chauliac University Hospital, Montpellier, France.
authors.forename: Makram
authors.initials: M
authors.lastname: Ziade
authors.affiliation: Oral, Maxillo-facial and Plastic Surgery Department, Gui De Chauliac University Hospital, Montpellier, France.
authors.forename: Marine
authors.initials: M
authors.lastname: Lefevre
authors.affiliation: Oral, Maxillo-facial and Plastic Surgery Department, Gui De Chauliac University Hospital, Montpellier, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Prud'homme
authors.affiliation: Oral, Maxillo-facial and Plastic Surgery Department, Gui De Chauliac University Hospital, Montpellier, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Yachouh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002921:Cicatrix / Q000517:prevention & control; D004311:Double-Blind Method; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D016038:Skin Transplantation / Q000009:adverse effects / Q000379:methods*; D013524:Surgical Flaps / Q000009:adverse effects / Q000098:blood supply*; D013529:Surgical Wound Dehiscence / Q000517:prevention & control*; D013536:Suture Techniques; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*; D055815:Young Adult
keywords: Breast reduction; Dermal flaps; Surgical technic; Surgical wound dehiscence