Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China; Department of Surgical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.
Department of Surgical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.
J Surg Res. 2015 Jan;193(1):492-6. doi: 10.1016/j.jss.2014.08.010. Epub 2014 Aug 12.
The extended latissimus dorsi (LD) flap has become a preferred method of breast reconstruction. However, donor site seroma is the most common complication of LD flap reconstruction. The purpose of this study was to investigate the effectiveness of OK-432 on postoperative drainage and seroma formation in the site of the LD myocutaneous flap donor site.
A retrospective study was conducted on 49 patients who underwent immediate breast reconstruction with extended LD flaps between July 2008 and September 2013. The patients received either OK-432 (OK-432 group, n = 24) or not (control group, n = 25) in the extended LD donor site. Outcome measures were obtained from the incidence and volume of postoperative seroma, total volume of back drains, the total drainage, indwelling period of drainage, and frequency of aspiration.
There were no statistically significant differences between the two groups in terms of age, body mass index, and flap size. The incidence of seroma was 41.7% in the OK-432 group and 72% in the control group (P = 0.032). There were also significant reductions in volume of postoperative seroma (P = 0.021), total drainage volume (P < 0.001), total volume of back drains (P < 0.001), indwelling period of drainage (P = 0.004), and frequency of aspiration (P = 0.008).
The use of OK-432 is a feasible option for the reduction or prevention of seroma formation at the donor site in patients undergoing immediate breast reconstruction using a LD myocutaneous flap for breast cancer.
延长背阔肌(LD)皮瓣已成为乳房重建的首选方法。然而,供区血清肿是 LD 皮瓣重建最常见的并发症。本研究旨在探讨 OK-432 对 LD 肌皮瓣供区术后引流和血清肿形成的效果。
回顾性分析 2008 年 7 月至 2013 年 9 月间 49 例行延长 LD 皮瓣即刻乳房重建的患者。患者在延长 LD 供区接受 OK-432(OK-432 组,n=24)或未接受 OK-432(对照组,n=25)。观察指标包括术后血清肿的发生率和体积、背部引流总容量、总引流量、引流留置时间和抽吸频率。
两组患者在年龄、体重指数和皮瓣大小方面无统计学差异。OK-432 组血清肿发生率为 41.7%,对照组为 72%(P=0.032)。术后血清肿体积(P=0.021)、总引流量(P<0.001)、背部引流总容量(P<0.001)、引流留置时间(P=0.004)和抽吸频率(P=0.008)均显著降低。
对于接受乳腺癌 LD 肌皮瓣即刻乳房重建的患者,OK-432 可减少或预防供区血清肿形成。