Pronin V I, Adamian A A, Smagin E N, Rozanov Iu L, Akimov A A, Tkach A V, Kudaĭbergenova I O
Khirurgiia (Mosk). 1994 Mar(3):37-9.
The creation of silicone endoprosthesis led to new approaches in solving the problems of plastic replacement of the breast after radical mastectomy. Two variants of reconstructive plastic operations with endoprosthetics of the breast were employed: group one--the formation of the seat of the endoprosthesis using a transposed musculocutaneous flap from the latissimus dorsi muscle; group two--the formation of the seat of the endoprosthesis by stretching the skin with a specially designed stretcher-expander and subsequent implantation of the endoprosthesis. The first method is rather injurious, sometimes cannot be performed because of anatomical contraindications, and is fraught with the development of necroses in the transposed tissues. Among 34 patients operated on by the first method two had marginal necrosis of the skin above the endoprosthesis. No complications were recorded among the 46 patients who underwent operation by the second method. The condition of the endoprosthesis and the tissues surrounding it was appraised in the immediate and late periods by radiological and ultrasonic examination. The variants of endoprosthetics of the breast which we applied may be employed with competence in clinical practice, but a reconstructive-plastic operation with the use of a skin expander is preferable.
硅胶乳房假体的发明为根治性乳房切除术后乳房整形替代问题带来了新的解决方法。采用了两种乳房假体重建整形手术方式：第一组——利用背阔肌移位肌皮瓣形成乳房假体植入腔；第二组——使用特制的皮肤扩张器拉伸皮肤，随后植入乳房假体，形成乳房假体植入腔。第一种方法创伤较大，有时因解剖学禁忌无法实施，且移位组织有发生坏死的风险。在采用第一种方法进行手术的34例患者中，有2例在乳房假体上方出现皮肤边缘坏死。采用第二种方法进行手术的46例患者未出现并发症。通过放射学和超声检查在术后即刻及后期对乳房假体及其周围组织的情况进行评估。我们应用的乳房假体植入方式在临床实践中可有效应用，但使用皮肤扩张器的重建整形手术更为可取。
