PURPOSE: The most common complication of a Wise pattern breast reduction is dehiscence of the wound at the inverted T junction. The inverted T-Junction, where the vertical and horizontal suture lines meet, has the greatest tension when compared to other aspects of the wound and is therefore prone to complication. A triangular skin flap (TSF) can decrease tension over the inverted T-junction and thus potentially decrease dehiscence rates in patients.
METHODS: A retrospective chart review was performed to identify adults (≥18 years) undergoing Wise pattern breast reductions between 2017 and 2020 by two surgeons with varying techniques of closure - with TSF vs traditional closure (TC). Patient demographics, etiology, type of closure, risk factors and complications were all analyzed.
RESULTS: A total of 75 patients underwent Wise pattern breast reduction, of these 47 patients had closure with a TSF. The average age (TC=49, TSF=48, P>0.05), BMI (TC=34.5, TSF= 31.7, P>0.05) and size of breast reduction (TCF=783g, TSF= 574g, P>0.05) were similar in both cohorts. When compared with a TC, patients with a TSF were less likely to have a T-junction dehiscence (TC=11, TSF=6, P=0.02, OR = 0.271 CI95% 0.073 - 0.76). Median follow up was 130 days (Range 8 - 679 days).
CONCLUSION: Wound dehiscence in breast reduction is a common problem. A simple triangular skin flap may hold the key to reducing T-junction dehiscence in this patient population.