Hongying W U, Shan Z C, Thakuri B
Xingtai County Hospital, Xingtai, Hebei, China.
Kathmandu Univ Med J (KUMJ). 2006 Jan-Mar;4(1):14-7.
To discuss the various factors which cause the common skin flap complications after radical operation for breast cancer.
Two hundred sixteen patients with T1-3N0-1M0 breast cancer underwent radical surgery at The Cancer Hospital of Xingtai City, China during 1995-2003. Patey mastectomy was performed in majority of patients. Skin flaps were dissected using scalpel after injecting adrenaline containing saline into subcutaneous tissue. Diathermy was used only to stop bleeding vessels. A subset of patients who developed abnormal vascularity of skin flaps, seroma collection and flap necrosis was analyzed. Pressure garment and suction drains were used routinely. Flap necrosis < 3cm(2) was allowed to heal with secondary intention whereas larger defects were skin grafted.
In 56 patients, flap associated complications were noted. Abnormal vascularity, flap necrosis and seroma collection were absorbed in 34 (15.7%), 13 (6%) and 9 (4.2%) patients, respectively. Eight patients (3.7%) required skin grafting. All patients were discharged with full recovery.
To minimize the skin flap complications after radical surgery for breast cancer, lesser use of cautery, injection of adrenaline containing solution into subcutaneous tissue, routine use of suction drains and application of pressure garment may be recommended.
探讨乳腺癌根治术后导致常见皮瓣并发症的各种因素。
1995年至2003年期间，216例T1 - 3N0 - 1M0期乳腺癌患者在中国邢台市肿瘤医院接受了根治性手术。大多数患者行Patey乳房切除术。在皮下组织注射含肾上腺素的生理盐水后，用手术刀解剖皮瓣。仅使用电灼来止血。对出现皮瓣血管异常、血清肿形成和皮瓣坏死的部分患者进行了分析。常规使用压力衣和负压引流管。皮瓣坏死面积<3cm²的创口允许二期愈合，而较大的缺损则进行植皮。
56例患者出现了与皮瓣相关的并发症。分别有34例（15.7%）、13例（6%）和9例（4.2%）患者出现血管异常、皮瓣坏死和血清肿形成。8例患者（3.7%）需要植皮。所有患者均康复出院。
为使乳腺癌根治术后皮瓣并发症降至最低，建议减少电灼的使用，在皮下组织注射含肾上腺素的溶液，常规使用负压引流管并应用压力衣。
