Zhang Xiaohui, Lin Yan, Sun Qiang, Huang Hanyuan
Department of Breast Surgery, Peking Union Medical College Hospital and Chinese Academy of Medical Science, Beijing, China.
Department of Breast Surgery, Peking Union Medical College Hospital and Chinese Academy of Medical Science, Beijing, China.
J Surg Res. 2015 Feb;193(2):738-44. doi: 10.1016/j.jss.2014.07.067. Epub 2014 Aug 6.
Recurrent periductal mastitis (PDM) is usually refractory to medical treatment and normally requires surgical intervention or even mastectomy. This study aimed to evaluate the effectiveness and safety of extended excision with transferring a random breast dermo-glandular flap (BDGF) in the treatment of severe PDM.
Between January 2010 and December 2011, 47 patients with recurrent PDM were consecutively and prospectively hospitalized for elective extended excision. A random BDGF was harvested from the ipsilateral breast tissue overlying the pectoralis major muscle and transferred to resurface the breast tissue defect. The donor site wound was closed using interrupted sutures. Main outcome measures included flap survivability, surgical morbidities, and follow-up cosmetic outcome.
All flaps survived uneventfully and all wounds healed by primary intention. PDM recurred in two patients (2/47, 4.3%) and required second-look surgery. The cosmetic outcome was self-evaluated to be excellent in 31.9% (15/47) of patients, good in 36.2% (17/47), acceptable in 21.3% (10/47), and poor in 10.6% (5/47), respectively. The donor site wounds healed uneventfully with minimal scarring.
Extended excision with transferring BDGF is an effective, safe treatment modality for recurrent PDM with a low-risk morbidity and favorable cosmesis.
复发性导管周围乳腺炎(PDM)通常对药物治疗无效,通常需要手术干预甚至乳房切除术。本研究旨在评估采用随机乳房真皮-腺体瓣(BDGF)转移的扩大切除术治疗重度PDM的有效性和安全性。
2010年1月至2011年12月期间,47例复发性PDM患者连续前瞻性住院接受择期扩大切除术。从胸大肌上方的同侧乳房组织中获取随机BDGF,并转移以修复乳房组织缺损。供区伤口采用间断缝合关闭。主要观察指标包括皮瓣存活率、手术并发症及随访美容效果。
所有皮瓣均顺利存活,所有伤口均一期愈合。2例患者(2/47,4.3%)PDM复发,需二次手术。美容效果自我评价为优秀的患者占31.9%(15/47),良好的占36.2%(17/47),可接受的占21.3%(10/47),差的占10.6%(5/47)。供区伤口一期愈合,瘢痕最小。
采用BDGF转移的扩大切除术是治疗复发性PDM的一种有效、安全的治疗方式,并发症风险低,美容效果良好。