扩张皮瓣联合游离植皮在局部晚期乳腺癌手术中的应用  

Application of expanded skin flap combined with free skin grafting in operation of breast cancer

作　　者：叶正青[1] 钟琰[1] 张王山[1] 丁海[1] 魏杨辉[2] 郭雄波[2] 

机构地区：[1]东南大学附属第二医院外一科,江苏南京210003 [2]南方医科大学珠江医院普外科,广东广州510282

出　　处：《中国现代医学杂志》2015年第9期99-101,共3页China Journal of Modern Medicine

基　　金：广东省医学科研基金项目(No:B2012330)

摘　　要：目的探讨扩张皮瓣联合游离植皮修复局部晚期乳腺癌手术后巨大软组织缺损的应用价值。方法对11例局部晚期乳腺癌行4个疗程化疗,化疗前先以亚甲蓝在肿瘤的体表轮廓纹身标记,并在患侧乳房下方腹壁皮下埋植扩张器,化疗期间逐渐注水扩张皮瓣,在完成乳腺癌改良根治术后即时取出水囊,利用扩张皮瓣和下腹壁游离皮瓣修复胸壁巨大软组织缺损。结果化疗过程顺利,11例患者皮瓣扩张良好,手术顺利,扩张皮瓣及游离植皮有效覆盖手术创面并实现Ⅰ期愈合,患者放疗耐受性好,短期随访未发现肿瘤胸壁复发。结论应用邻近扩张皮瓣联合游离植皮修复乳癌术后胸壁巨大软组织缺损的效果良好。【Objective】To explore the application value of free skin grafting and expanded skin flap in the operation for locally advanced breast cancer. 【Methods】Chemotherapy was performed in 11 patients with locally advanced breast cancer. Methylthioninium chloride tattoo was used to mark the contour of the tumor surface before chemotherapy and the expander was implanted subcutaneously in the abdominal wall below the diseased breast. The hyponome was gradually expanded during chemotherapy and taken out when the operation was finished. The expanded skin and hypogastric free skin flap were used to repair the defect of soft tissue in the chest wall.【Results】All the patients went well with chemotherapy and the skin flap played a good role during the operation. All the cases had primary healing and good tolerance during radiotherapy. There was not chest wall palindromia.【Conclusions】It is a good way to use expanded flap and hypogastric free skin for the repair of chest wall defect after breast cancer operation.

关 键 词：扩张皮瓣 乳腺癌 化疗 游离植皮 

分 类 号：R730.261[医药卫生—肿瘤]