Kagaya Yu, Arikawa Masaki, Kageyama Daisuke, Sekiyama Takuya, Akazawa Satoshi
Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, Japan.
Plast Reconstr Surg Glob Open. 2018 Oct 16;6(10):e1983. doi: 10.1097/GOX.0000000000001983. eCollection 2018 Oct.
The presence of seroma after breast tissue expander (TE) insertion for a long duration can cause infection and purulency; thus, obvious fluid collection around TEs should be drained as early as possible. However, due to the risk of puncture, it may not be possible to completely drain the fluid if it is located above the TE. To manage such cases, we used an 18-gauge blunt cannula and achieved good results. Among 98 cases in which breast reconstruction was performed with a TE, 5 patients had symptoms of infection with fluid collection just above the TE. In all 5 cases, resolution of the infection was observed in an outpatient setting without the removal or puncture of the inserted TE, by performing a drainage technique using an 18-gauge blunt cannula. An 18-gauge blunt cannula minimized the risk of expander rupture during drainage and enabled the complete aspiration of fluid, even when it was located just above the TE; thus, the resolution of infection with the preservation of the expander was possible in cases that would otherwise have been impossible to treat without the removal of the TE. This drainage procedure using an 18-gauge blunt cannula is considered to be simple, safe, and sure, with benefits that exceed the risk; thus, there should be no reason to hesitate in performing this drainage procedure, even in cases involving slight fluid collection around the TE.
乳房组织扩张器（TE）植入后长期存在血清肿可导致感染和化脓；因此，TE周围明显的积液应尽早引流。然而，由于穿刺风险，如果积液位于TE上方，可能无法完全引流。为处理此类情况，我们使用了18号钝头套管针并取得了良好效果。在98例行TE乳房重建的病例中，有5例患者出现TE上方积液伴感染症状。在所有5例病例中，通过使用18号钝头套管针进行引流技术，在门诊观察到感染得到缓解，而无需移除或穿刺已植入的TE。18号钝头套管针在引流过程中使扩张器破裂的风险降至最低，即使积液位于TE正上方也能完全抽出液体；因此，并在一些不取出TE就无法治疗的病例中，保留扩张器并解决感染问题成为可能。这种使用18号钝头套管针的引流方法被认为简单、安全且可靠，益处超过风险；因此，即使在TE周围有少量积液的情况下，进行这种引流操作也不应有任何犹豫。
