[Dermatoplasty in the treatment of necrotic mastitis and breast erysipelas].

The authors had 15 female patients aged from 20 to 35 years with various diseases of the breast which were marked by necrosis of the skin and subcutaneous fat with involvement of 18 to 100% of the breast surface. The necrosis was caused by phlegmonous and infiltrative abscess producing forms of mastitis in 18 and by erysipelas in 7 cases. Necrotic mastitis and erysipelas developed in the first 2 weeks after delivery, as a rule, in patients with marked concomitant diseases of the heart and vessels. The patients were hospitalized 7 to 29 days after the onset of the disease. The development of severe forms of breast diseases was promoted by intensive manual abstraction of milk from the breast and retromammary antibiotic-novocaine blockades. After an operative intervention a complex of therapeutic measures was applied including semisynthetic antibiotics, agents containing protein globulin fractions, and dry and native blood plasma, and artificial polyuria with preceding hemodilution was produced. All patients underwent dermatoplasty with the use of a free split perforated skin graft. Lactorrhea in the region of the granulations was not a contraindication for surgical closure of the wound. Perforation of the skin graft was regarded a forced measure because the secretion of milk led to inevitable rejection of the transplant. The applied treatment produced quite satisfactory cosmetic and functional results.