Loss of Umbilicus Poor perfusion can lead to loss of the umbilicus. If the umbilicus becomes necrotic, the tissue is excised and the abdominal wall is closed. Again, excision of the necrotic tissue is performed immediately to avoid bacterial colonization or infection. Reconstruction of the umbilicus can be attempted after six months. Incisional Hernia Abdominal wall laxity may occur in the area from which the rectus abdominus has been harvested.
Treatment requires repair of the abdominal wall laxity using marlex mesh.
Should it occur, excision of necrotic portions is required, followed by wound closure. Complete flap loss is very rare and typically occurs during elevation. If the flap is not viable, it is discarded. The abdominal incision is closed using the method described in the TRAM donor site closure section, whereas the mastectomy wound is closed without reconstruction. Reconstructive alternatives are then discussed with the patient after recovery from surgery.