Skin banking closure technique in immediate autologous breast reconstruction

Wound complications following skin-sparing mastectomy and immediate breast reconstruction are common. Most reports cite wound complication rates in the 10 to 16 percent range, with active smoking and high body mass index the main risk factors. Although many wound complications are minor and can be allowed to heal by secondary intention, in some instances secondary wound healing after breast reconstruction causes significant morbidity, may delay planned postoperative radiation treatment, or may lead to inferior aesthetic results that require additional operative procedures. We present a skin banking closure technique to manage mastectomy skin flaps when the viability is unclear in immediate autologous breast reconstruction. This approach is based on the basic principle of delayed wound closure, with a planned second-look procedure, where the time interval permits demarcation of nonviable tissue. These concepts can be generalized to other clinical scenarios where tissue transfer with a cutaneous component is used to reconstruct a site where the recipient site skin viability is in question. Copyright ©2007 by the American Society of Plastic Surgeons.