Kroll S S, Goepfert H, Jones M, Guillamondegui O, Schusterman M
Section of Plastic Surgery, University of Texas M. D. Anderson Cancer Center, Houston 77030.
Ann Plast Surg. 1990 Aug;25(2):93-7. doi: 10.1097/00000637-199008000-00003.
One hundred sixty-eight pectoralis major muscular and myocutaneous flaps performed at the University of Texas M. D. Anderson Cancer Center during the past five years were reviewed retrospectively to determine complication rates following operation and to evaluate the effect of risk factors such as smoking, obesity, sex, previous radiotherapy, and tumor stage on the incidence of such complications. The overall rate of complications was 63%; however, most of these complications were self-limited, and the rate of total flap loss was only 2.4%. The risk of a complication developing was increased slightly in patients who smoked cigarettes and in patients with larger tumors. Obesity and previous radiotherapy had no effect on complication rates. Women who underwent pectoralis major myocutaneous flaps had a higher rate of flap necrosis than did men, presumably because of the interposition of breast tissue between the muscle and the skin paddle. In patients who had muscle flaps (without skin paddles), sex had no influence on complication rates. In all groups of patients, flaps consisting of muscle alone had fewer complications than did flaps with a cutaneous component.
对过去五年在德克萨斯大学MD安德森癌症中心进行的168例胸大肌肌瓣和肌皮瓣手术进行了回顾性研究，以确定术后并发症发生率，并评估吸烟、肥胖、性别、既往放疗和肿瘤分期等风险因素对此类并发症发生率的影响。总体并发症发生率为63%；然而，这些并发症大多为自限性，皮瓣完全坏死率仅为2.4%。吸烟患者和肿瘤较大的患者发生并发症的风险略有增加。肥胖和既往放疗对并发症发生率无影响。接受胸大肌肌皮瓣手术的女性皮瓣坏死率高于男性，推测是因为肌肉和皮瓣之间存在乳腺组织。在接受肌瓣（无皮瓣）手术的患者中，性别对并发症发生率无影响。在所有患者组中，仅由肌肉组成的皮瓣比带有皮肤成分的皮瓣并发症更少。
