皮瓣二次扩张、乳房假体植入重建乳腺癌根治植皮术后胸壁“补丁样”瘢痕乳房缺损  

The using of flap secondary expansion and breast prosthesis implantation in breast reconstruction in patients with patch-like scars on the chest wall after radical mastectomy and skin grafting operation

作　　者：陈静[1] 张晨芳[2] 梁祎诺[1] 徐伟熙[1] 钟记华[1] 

机构地区：[1]东莞市虎门医院普外科,广东东莞523902 [2]广州军区广州总医院普外科,广东广州510010

出　　处：《中国肿瘤外科杂志》2012年第4期200-202,共3页Chinese Journal of Surgical Oncology

摘　　要：目的探讨皮瓣二次扩张在乳腺癌根治植皮术后乳房重建中的可行性,评价该方法的优越性。方法 10例行乳腺癌改良根治术+游离植皮术后胸壁"补丁样"瘢痕患者,在瘢痕下、胸大肌深面埋置较对侧乳房容积稍大的扩张器,定期注水扩张皮瓣达到可修复瘢痕切除后的缺损面积后,切除瘢痕缝合创面,伤口愈合后,扩张器二次注水,达到与对侧乳房基本对称时,取出扩张器,更换乳房假体。结果 10例患者"补丁样"瘢痕完全切除,皮瓣成活,再造乳房外观较满意,无并发症发生。结论皮瓣二次扩张、假体植入是修复乳腺癌根治术后胸壁"补丁样"瘢痕的一种安全、有效、损伤小的乳房重建方法 。Objective To discuss the feasibility of flap secondary expansion in breast reconstruction after radical mastectomy and skin grafting operation, and evaluate its superiority. Methods The research was based on 10 patients with patch-like scars on the chest wall after radical mastectomy and skin grafting operation. Dur- ing the reaserch, we buried a dilator, which was lightly lager than the contralateral breast, in the deep side of scars and pectoralis major, and injectd water regularly to expanse the flap to the defected size, then removed the scars, sutured the wounds. When the wouuds were healed, we injected water again to the same size of the con- tralateral breast. At last, we removed the dilator and replaced with breast prosthesis. Results We completely removed the patch-like scars of the 10 cases. The flap survived, the appearance of the reconstructed breast were satisfactory, and no complications occurred. Conclusions Flap secondary expansion and breast prosthesis im- plantation is safe, effective and less damaged in breast reconstruction.

关 键 词：乳腺癌根治术 胸壁“补丁样”瘢痕 皮瓣二次扩张 乳房假体 乳房重建 

分 类 号：R737.9[医药卫生—肿瘤]