乳腺癌术后皮瓣坏死原因分析

Analysis on Causes of Skin Flap Necrosis Following Operation for Breast Cancer

目的:分析乳腺癌术后皮瓣坏死原因及预防措施。方法:手术治疗乳腺癌152例,其中根治术30例,改良根治术122例,统计分析其术后皮瓣坏死率和术后皮瓣坏死原因。结果:152例患者中36例皮瓣坏死(23.7%),皮瓣坏死与皮缘的对称性、真皮下血管网的完整性、伤口与腋窝的加压与否明显相关(P<0.01),与基础病、手术方式、游离皮瓣的工具、止血剂的应用无关(P>0.05)。结论:真皮下血管网的完整性的破坏是术后皮瓣坏死的主要原因之一,提高其解剖认识对乳腺癌术后皮瓣坏死的预防有一定的临床价值。

Objective ：To analyze causes of skin flap necrosis following operation for breast cancer and explore its preventive measures. Methods：152 patients with breast cancers received operations, including 30 cases of radical mastectomy and 122 modified radical mastectomy. The incidence and causes of skin flap necrosis were calculated and analyze. Results：Skin flap necrosis occurred in 36 of the 152 patients following operations （23.7%）, The necrosis was related to the symmetry of skin edge ,integrality of subdermal vascular plexus and whether or not pressurizing on the wound and axillary fossa（ P 〈0. 01 ） ,but not related to the original disese, modus operandi,tools by which to free skin flap and administration of haemostatics. Conclusions：One of maln causes induced postoperative skin flap necrosis was that the integrality of subdermal vascular plexus was destroyed, To further understand the anatomy of subdermal vascular plexus will be benefits to prevent postoperative skin flap necrosis.