Chilson T R, Chan F D, Lonser R R, Wu T M, Aitken D R
Department of Surgery, Loma Linda University Medical Center, California.
Am Surg. 1992 Dec;58(12):750-4.
The most common mastectomy-associated complication is seroma formation. Seromas can be associated with other more serious complications such as skin flap necrosis, delayed wound healing, infection, and lymphedema. The flap tacking procedure that closes the axillary fossa dead space and tacks the mastectomy flaps to the chest wall has been suggested as one potential technique to reduce the incidence of postmastectomy seromas. This institution-wide study of modified radical mastectomies demonstrated a significant decrease (P < 0.0381) in the incidence of seroma when flap tacking was performed. Women who developed a seroma, compared to those who did not, averaged nearly twice as any office visits in the first 2 months after the operation. Distribution of office visits between the seroma patients and nonseroma patients was significant (P < 0.0001). When practiced by several surgeons, the flap tacking procedure 1) reduces postmastectomy seromas and 2) reduces the amount of postoperative patient office visits and care.
最常见的乳房切除术相关并发症是血清肿形成。血清肿可能与其他更严重的并发症相关，如皮瓣坏死、伤口愈合延迟、感染和淋巴水肿。有人提出皮瓣固定术，即封闭腋窝死腔并将乳房切除皮瓣固定于胸壁，作为一种可能降低乳房切除术后血清肿发生率的技术。这项针对改良根治性乳房切除术的全院范围研究表明，进行皮瓣固定时血清肿发生率显著降低（P < 0.0381）。与未发生血清肿的女性相比，发生血清肿的女性在术后头2个月的门诊就诊平均次数几乎是其两倍。血清肿患者和非血清肿患者之间的门诊就诊分布具有显著性差异（P < 0.0001）。当由几位外科医生实施时，皮瓣固定术1）可减少乳房切除术后血清肿，2）可减少术后患者的门诊就诊次数和护理量。
