ABSTRACT
Revision of an irradiated flap often leads to poor healing because tissues have lost the capacity for normal fibrin deposition and healing secondary to dysfunctional fibroblast stem cells. Irradiation of a flap can defeat the purpose of transferring well-vascularized tissue to an irradiated chest wall, where the objective is to transfer non-irradiated cellular elements. Placement of an acellular dermal matrices (ADM) in an implant-based reconstruction that will be irradiated may reduce the chance and extent of breast revision. Utilization of ADM can also render any revision more robust and safe by providing a strong layer for mastectomy wound closure in the event that an implant exchange is required. Irradiated flaps have lost the capacity for normal wound healing, and attempts at revision may lead to wound healing problems. Thus, wounds can be very slow to heal or may require a vacuum-assisted closure device or even fashioning of another flap.
