Carlson G W
Division of Plastic Surgery, Emory University School of Medicine, Atlanta, Georgia.
Cancer. 1994 Jul 1;74(1 Suppl):436-9. doi: 10.1002/cncr.2820741332.
Breast reconstruction has undergone a steady evolution since the introduction of the silicone gel prosthesis in the early 1960s. Current restrictions of the use of breast implants have increased the reliance on autologous tissue reconstruction. The improvement in the quality of breast reconstruction can be attributed in part to a refinement in mastectomy technique. There is an increasing emphasis on skin preservation, which makes it easier to match the remaining breast. In this paper, various methods, including tissue expansion, the latissimus dorsi flap, the transverse rectus abdominis musculocutaneous flap, and free flaps, are described. The indications as well as potential complications for each methods also are discussed. Local recurrence after breast conservation generally necessitates a total mastectomy. Radiation fibrosis and endarteritis interfere with skin blood supply and impair wound healing. Reconstruction in this setting has a potential for increased operative morbidity. Treatment options, including techniques to reduce potential complications, are presented.
自20世纪60年代初引入硅胶假体以来，乳房重建技术一直在稳步发展。目前对乳房植入物使用的限制增加了对自体组织重建的依赖。乳房重建质量的提高部分归功于乳房切除术技术的改进。现在越来越强调保留皮肤，这使得剩余乳房的匹配更加容易。本文描述了多种方法，包括组织扩张、背阔肌皮瓣、腹直肌横形肌皮瓣和游离皮瓣。还讨论了每种方法的适应证以及潜在并发症。保乳术后局部复发通常需要进行全乳切除术。放射性纤维化和动脉内膜炎会干扰皮肤血液供应并损害伤口愈合。在这种情况下进行重建有增加手术并发症的风险。本文还介绍了包括减少潜在并发症的技术在内的治疗选择。
