Fixation of the skin to the chest wall and axillary fossa by means of subcutaneous sutures after radical amputation of the breast significantly decreases the morbidity of this operation. It has been long recognized by plastic surgeons that skin must be held securely in place if optimum healing is to be obtained. Following breast amputation, this has been a problem because of the almost constant motion of the chest wall and the depth and irregularity of the axillary fossa. Fixation of the skin to the chest wall and axilla by pressure alone has been only partially successful, although ingenious methods of applying external pressure have been employed.
Halsted, in 1913, advocated fixation of the skin over the axillary vessels by suturing the skin edge to the deep structures. The covering flap was made short, so that the edge was sutured "to the fascia just below the first rib in such
Larsen BB. FIXATION OF SKIN FLAPS BY SUBCUTANEOUS SUTURES IN RADICAL MASTECTOMY. JAMA. 1955;159(1):24. doi:10.1001/jama.1955.02960180026006
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