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Intraoperative skin traction for closure of hygienic bilateral mastectomy wound: case report

INTRODUCTION: The post-mastectomy chest wall defects require reconstruction by a safe and efficient procedure. In cases of local recurrence, especially bilateral, surgical intervention should be indicated given the patient's general condition and life expectancy. The intraoperative traction is a technique with low morbidity and rapid execution, reducing the scars from the use of flaps. CASE REPORT: Female patient, 45 years old, after diagnosis of recurrence in right breast and a new tumor in left breast, was submitted to hygienic bilateral mastectomy with dissection of left axillary lymph nodes. Opted for intraoperative skin traction of the chest wall wound edges for primary closure due to the general state of the patient. Traction was performed according to the Góes et al. technique, using prolene 2 sutures, stretching the skin for ten minutes, resting for two minutes, until they gain sufficient proximity of the edges of the wound to perform primary suture. This was achieved after three cycles of tension and relaxation. The procedure lasted two hours and was used aspiratory drainage with portovac 3.2 drain, which was removed after 7 days. The patient had no pain complaints, suture without dehiscence or any other complication. CONCLUSION: The intraoperative traction proved to be a safe, functionally efficient, with lower costs and lower morbidity, to close wounds resulting from hygienic bilateral mastectomy hygienic.

Skin; Traction; Mastectomy; Breast


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