Berrino P, Santi P
Department of Plastic Surgery, National Institute for Cancer Research, Genoa, Italy.
Ann Plast Surg. 1988 Sep;21(3):264-72. doi: 10.1097/00000637-198809000-00015.
The techniques for transverse rectus abdominis musculocutaneous flap planning, which have previously been described in international literature, do not provide adequate guidelines for preoperative marking that can be followed in patients with different types of contralateral breast. Because in most patients we tend to reconstruct the new breast on the model of the contralateral one without significant changes in the patient's body image, some parameters were needed that could provide adequate preoperative marking. The technique we describe for preoperative planning is simple and reliable and can be used in most patients. It allows immediate deepithelialization and tailoring of the dermoadipose extensions of the flap at the beginning of the operation. In our experience this type of preoperative marking has significantly reduced operative time and the need for secondary correction and contralateral mammaplasty. The incidence of marginal flap necrosis and liponecrosis has also been reduced because minimal contralateral random portion of the skin island is used.
先前国际文献中所描述的腹直肌横形肌皮瓣规划技术，并未为不同类型对侧乳房患者提供可遵循的充分术前标记指南。因为在大多数患者中，我们倾向于按照对侧乳房的模型重建新乳房，而不对患者的身体形象进行显著改变，所以需要一些能够提供充分术前标记的参数。我们所描述的术前规划技术简单可靠，可用于大多数患者。它允许在手术开始时立即对皮瓣的真皮脂肪延伸部分进行去上皮化和裁剪。根据我们的经验，这种术前标记显著减少了手术时间以及二次矫正和对侧乳房成形术的需求。由于使用的皮岛对侧随机部分最少，皮瓣边缘坏死和脂肪坏死的发生率也有所降低。
