Umbilical Inset Incision Type Influences Abdominal Donor Site Healing in Autologous Breast Reconstruction
Kshipra Hemal, Thomas Sorenson, Rebecca Lisk, Malory Alexis, Sachin Chinta, Alay Shah, Rebecca Vernon, Carter Boyd, John Muller, Angela Volk, Jamie P. Levine, Vishal Thanik, Nolan Karp, Mihye Choi, Oriana CohenABSTRACT
Background
Delayed abdominal wound healing remains a common complication following abdominally based autologous breast reconstruction. We hypothesized that the type of umbilical inset incision impacts the incidence of delayed wound healing due to differential disruption of abdominal wall vascularity, particularly in the infraumbilical region.
Methods
A retrospective review was conducted of all patients undergoing abdominally based autologous breast reconstruction at a single center between 2014 and 2021. The primary outcome was delayed abdominal wound healing, classified as major (requiring readmission or reoperation), minor (managed with outpatient care, antibiotics, or debridement), or both. Umbilical inset incision type was evaluated as a predictor using univariate and multivariate analysis.
Results
Four hundred and eighty‐eight patients and 791 flaps were included. Patients were on average 51 ± 9 years old and had a median body mass index of 28 (
Conclusion
Abdominal wall vascularity likely plays a critical role in donor site healing following autologous reconstruction. In this large cohort, inverted‐U and vertical umbilical inset incisions were associated with the highest rates of wound healing complications.