Kubo Kazuyuki, Takei Hiroyuki, Matsumoto Hiroshi, Hamahata Atsumori
Division of Breast Surgery, Saitama Cancer Center, Saitama 362-0806, Japan.
Department of Breast Oncology, Nippon Medical School, Tokyo 113-8603, Japan.
Oncol Lett. 2017 Aug;14(2):2347-2352. doi: 10.3892/ol.2017.6411. Epub 2017 Jun 19.
Resection for locally advanced breast cancer (LABC) or malignant phyllodes tumors may cause a large skin defect with bone exposure. Although skin grafts are frequently used to cover such defects, they can result in poor cosmetic outcomes and graft acceptance is dependent upon the condition of the recipient site. To overcome the limitations of skin grafts, various flaps have been developed to cover such defects. The present study used a rhomboid flap for the coverage of skin defects after mastectomy and breast-conservative surgery (BCS). A total of 11 patients with malignant breast cancer underwent reconstructive surgery using the rhomboid flap between September 2011 and December 2013 (mastectomy, 9 patients; BCS, 2 patients). Skin resection size, axillary lymph node dissection, bone exposure, length of surgery, wound complications and whether preoperative/postoperative adjuvant therapy was received were analyzed. The maximum size of skin defect covered with the rhomboid flap in the present study was 20×20 cm. There were no major wound complications and all patients underwent postoperative adjuvant therapy on schedule. During BCS, a portion of the flap was used for augmentation of the breast, in addition to coverage of the skin defect, which resulted in good cosmetic outcomes. The rhomboid flap can be quickly and easily fashioned, and it does not require any special instruments.
局部晚期乳腺癌(LABC)或恶性叶状肿瘤的切除可能导致大面积皮肤缺损并伴有骨外露。尽管皮肤移植常用于覆盖此类缺损,但可能导致美容效果不佳,且移植的接受程度取决于受区情况。为克服皮肤移植的局限性,已开发出多种皮瓣来覆盖此类缺损。本研究采用菱形皮瓣覆盖乳房切除术后和保乳手术(BCS)后的皮肤缺损。2011年9月至2013年12月期间,共有11例恶性乳腺癌患者接受了使用菱形皮瓣的重建手术(乳房切除术9例;保乳手术2例)。分析了皮肤切除大小、腋窝淋巴结清扫情况、骨外露情况、手术时长、伤口并发症以及是否接受术前/术后辅助治疗。本研究中菱形皮瓣覆盖的皮肤缺损最大尺寸为20×20 cm。未出现严重伤口并发症,所有患者均按时接受了术后辅助治疗。在保乳手术中,除了覆盖皮肤缺损外,皮瓣的一部分还用于乳房增大,美容效果良好。菱形皮瓣制作快速简便,且不需要任何特殊器械。