摘要
目的探讨乳腺癌改良根治术不同皮瓣处理方法对术后皮下积液及切口皮缘坏死的影响。方法回顾分析4年余行乳癌改良根治术(保留胸大、小肌)1 1 9例的临床资料,分析术中4种皮瓣处理方式的术后皮下积液及切口皮缘坏死的情况。结果1 1 9例患者术后发生皮下积液和/或皮缘坏死共4 3例。用横切口的7 9例中,术后积液1 3例,皮缘坏死3例;用纵切口4 0例中积液2 0例,皮缘坏死7例;用“皮瓣处理1”6 0例中积液2 3例,皮缘坏死8例;用“皮瓣处理2”5 9例中积液1 0例,皮缘坏死2例。结论横切口加1/4 0 0肾上腺素生理盐水皮下注入,加刀片分离皮瓣、加“铆钉”式缝合固定皮瓣的术式能有效地减少术后皮下积液和切口皮缘坏死的发生率。
Objective To evaluate the effect of different skin flap management methods on post operative subcutaneous fluid collection and skin flap necrosis after modified radical mastectomy for breast cancer. Methods A retrospectively analysis of clinical data of 119 cases of breast cancer operated by modified radical mastectomy in our hospital in recent four years. Statistically analyse the relationship between 4 different skin flap management methods to postoperative subcutaneous fluid collection and skin flap necrosis. Results 43 out of 119 cases developed postoperative subcutaneous fluid collection and/or skin flap necrosis. There were 13 cases with complication of subcutaneous fluid collection, 3 cases with skin flap necrosis among 79 cases treated by transverse incision ; 20 cases with complication of subcutaneous fluid collection, and 7 cases of skin flap necrosis among 40 cases treated by longitudinal incision; 23cases with complication of subcutaneous fluid collection, and 8 cases of skin flap necrosis among 60 cases treated by “ skin flap management type one” ; 23 cases with complication of subcutaneous fluid collection, and 2 cases of skin flap necrosis among 59 cases treated by “skin flap management type two ” Conclusions A transverse incision after subcutaneous injection of 1 ： 400 adrenaline saline solution, plus the use of scalpel dissection and the technique of skin flap fixation by the “rivet ” method can effectively decrease postoperative development of subcutaneous fluid collection and necrosis of incisional skin margins.
出处
《中国普通外科杂志》
CAS
CSCD
2005年第9期667-669,共3页
China Journal of General Surgery
