Results
The profiles of all nine female patients are presented in Table 1. The mean age of the patients was 64.78 years (range, 44–85 years) and their mean BMI was 27.12 kg/m2 (range, 21.90–35.87 kg/m2); one of them was obese (BMI > 30). None of the patients smoked. Of the three patients with comorbidities, one had type II diabetes mellitus (DM), and the other two had received neoadjuvant chemotherapy. All of them were in the advanced stage of breast cancer and underwent unilateral MRM. One of them received delayed reconstruction. The mean size of the defect area after MRM and skin graft size for reconstruction were 399 and 240 cm2, respectively. Most of the skin graft was harvested from the scalp, followed by the thigh area. We applied NPWT at −50 mmHg in the continuous mode for four days. After two weeks, the mean graft take was 96.11%. Two of them developed seroma and required aspiration at the donor site. Partial skin graft necrosis occurred in one patient, and healed after wound care.
Case1
The first case was a 59-year-old woman diagnosed with infiltrating ductal carcinoma of left breast, cT4bN1M1, stage IV. She had received neoadjuvant chemotherapy with epirubicin and cyclophosphamide followed by docetaxel. Surgical intervention with left MRM + axillary lymph node dissection (ALND) combined with LD muscle flap + STSG harvested from the scalp was performed smoothly (Fig. 1A, 1B). After immediate breast reconstruction, we applied NPWT over the entire wound at −50 mmHg in the continuous mode for four days (Fig. 1C). The patient exhibited satisfactory results at 3 months after the surgery (Fig. 1D).
Case 2
The second patient was a 57-year-old woman diagnosed with invasive lobular carcinoma of left breast, cT4bN2M1, stage IV, with liver and bone metastasis. She had received neoadjuvant chemotherapy with Taxatere + Herceptin prior to the surgery. Left breast MRM + ALND was performed, combined with LD flap + STSG (Fig. 2A, 2B). NPWT was applied postoperatively for four days (Fig. 2C). The progression was fair without any complication. The patient exhibited satisfactory results at three months after the surgery (Fig. 2D).