Post- Mastectomy and TUG Flap
Reconstruction Revision
Sarah Keilson
Procedure observed 2/16/12 Highland Hospital
Information available at cias.rit.edu/~srk5668/surgery2_112/breast.html
After viewing this presentation, you will be able to:
•
Make incisions for a post-mastectomy/TUG flap reconstruction revision
•
Remove necrotic tissue from previous TUG flap procedure, leaving
anastomosed vessels behind
•
Harvest and process fat from upper abdominal region
•
Insert fat graft into the breast
•
Suture close incisions with continuous running stitch
Objectives
1
Failed TUG Flap Reconstruction
Patient previously had mastectomy with TUG Flap Breast Reconstruction (Transverse Upper Gracilis Flap).
Vasculature taken as part of the TUG flap graft was anastomosed to axillary vasculature, but graft tissue died.
Healthy fat from upper
abdomen will be used to
replace necrotic fat graft.
Incision 3
Incisions:
1.
2.
3.
Lateral breast
Upper abdomen
Medial breast
Incision 2
Incision 1
Orientation and Background
2
Incision 1: Remove Necrotic Tissue
Dissect and remove necrotic tissue from previous reconstruction.
3
2
Do not remove vasculature anastomosed in previous reconstruction.
1
Leave anastomosed vessels behind
Step One
3
Incision 2: Harvest Abdominal Fat
Harvest fat using a liposuction cannula.
3
2
Add Lactated Ringer’s to harvested fat and transfer to large syringes.
Remove settled blood (blood cells in harvested fat stops angiogenesis).
Step Two
1
4
Incision 3: Inject Harvested Fat
Inject harvested fat into medial side of breast to replace necrotic tissue.
Step Three
3
2
1
5
Suture Close Incisions
3
Close all incisions with continuous running stitches.
2
Step Four
1
6
Works Cited
•
“TUG Flap Breast Reconstruction “(Transverse Upper Gracilis Flap).” Prima of
South Texas. N.p., 2012. Web. 25 Feb. 2012.
<http://www.prma-enhance.com/>.
•
“Breast.” Virtual Medical Centre. N.p., 21 Feb 2012. web. 25 Feb. 2012.
<http://www.virtualmedicalcentre.com/>.
•
“TUG Flap, Inner Thigh Flap Breast Reconstruction.” BreastReconstruction.org
The Comprehensive Resource for Breast Reconstruction. N.p., n.d. Web. 25
Feb. 2012.
<http://www.breastreconstruction.org/>.
Works Cited
7