Department of Plastic and Reconstructive Surgery, Peking University Third Hospital, Haidian District, Beijing, 100191, P. R. China.
Department of Plastic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, P. R. China.
Sci Rep. 2020 Apr 21;10(1):6753. doi: 10.1038/s41598-020-63721-1.
Flap necrosis is a common complication after mastectomy, and nitroglycerin (NTG) ointment has been used successfully to treat it. However, it is not clear whether topical NTG can completely prevent the occurrence of flap necrosis after breast cancer surgery, and it is also unclear whether this treatment may cause side effects. Three randomized controlled trials (RCTs) and two retrospective cohort studies (RCSs) were included in our investigation. This meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We found that NTG significantly reduced the rates of mastectomy flap necrosis, full-thickness flap necrosis, and debridement as well as the rate of early complications other than flap necrosis. However, there was no significant difference in drug-related adverse reactions, explantation, superficial flap necrosis, infection, hematoma or seroma between the NTG and placebo groups.
皮瓣坏死是乳房切除术后的一种常见并发症，硝酸甘油（NTG）软膏已成功用于治疗该病。然而，尚不清楚局部 NTG 是否能完全预防乳腺癌手术后皮瓣坏死的发生，也不清楚这种治疗是否会引起副作用。我们的研究纳入了三项随机对照试验（RCT）和两项回顾性队列研究（RCS）。这项荟萃分析是根据系统评价和荟萃分析的首选报告项目（PRISMA）指南进行的。我们发现，NTG 可显著降低乳房切除术皮瓣坏死、全层皮瓣坏死和清创的发生率，以及皮瓣坏死以外的早期并发症发生率。然而，NTG 组与安慰剂组之间在药物相关不良反应、假体取出、浅层皮瓣坏死、感染、血肿或血清肿方面无显著差异。
