微创缝合局部加压包扎预防乳癌术后皮瓣坏死

Microtraumatic suture and local strapping of operated chest wall to prevent necrosis of skin flap after radical operation of mastocarcinoma

目的 报告一种微创缝合皮瓣、胸壁局部加压包扎预防乳腺癌根治术后皮瓣坏死的方法。方法 乳腺癌根治术或改良根治术缝合皮瓣时,用细皮针1号线小边距缝合皮缘,两侧皮瓣基底部外侧的胸壁间断缝线,局部“打包”加压包扎。结果 本组268例均无明显皮瓣坏死。有13例因淋巴漏缝合处3～5cm裂开,经换药40d内愈合。结论 微创缝合皮缘及皮瓣局部“打包”加压包扎是一种较好的预防乳癌术后皮瓣坏死的方法。

Objective To report an operation of microtraumatic suture and local strapping of operated chest wall to prevent necrosis of skim flap after radical operation of mastoearcinoma. Methods The edge of skin flap was suture with thin needle and thin thread. The margin of suture to the wound edge was 0.5-1 mm and the distance between sutures was 5mm. Theskin and subcutaneous tissue 2-4 cm outside the base of skin flap was sutured with 5-7 sutures and the threads were used to strap the skin flap. Results There were no distinct necrosis of skin flap in all of 268 cases. Small ecchymosis of was found in 13 cases and all recovered within 2 weeks after the rele ase of strapping. Lymphatic leakage and 3 - 5cm dehiscence of suture was found in 3 cases and was cured with dressing change within 40 days. Conclusion Microtraumatic suture and local strapping of operated chest wall is a better technique to prevent necrosis of skin flap after radical operation of mastoearcinoma.