Managing Complications

The abdominal donor site is routinely used in the harvest of tissue for free flap breast reconstruction. Over two decades of outcomes studies have repeatedly demonstrated that use of the abdominal donor site is a safe and reproducible technique with which to reconstruct the breast mound.1–8

Flap harvest ideally concludes with primary closure of the donor site under minimal tension, ultimately providing an aesthetically pleasing abdominal contour. Despite the reliability and aesthetic benefit of the abdominal wall donor site, there can be an understated component of postoperative delayed healing (Figs. 1 and 2).

Risk factors for developing abdominal wound complications following free flap breast reconstruction have been delineated. Obesity has been often cited, along with other comorbidities typically associated with poor wound healing.9–16

Routine delayed healing can, however, progress to chronic abdominal wounds that persist for greater than 3 to 6 months after the initial reconstruction. In our experience, chronic abdominal wounds