荷包缝合加局部皮瓣转移修复乳头乳晕部皮肤软组织缺损

Reconstruction of the breast after excision of Paget's disease at nipple area and surrounding areola tissue using Purse-string suture and local flap transfer method

目的探讨一种Paget病乳头乳晕部皮肤软组织切除后的理想修复方法。方法5例单纯乳头乳晕处乳房湿疹样癌患者在病灶切除后,通过设计乳腺下部乳晕大小的带皮下软组织蒂的皮瓣,并将其向上推移到原乳头乳晕处与周围荷包缝合收拢的皮肤及软组织缝合的方法修复乳房中央的皮肤软组织缺损。结果5例患者均取得了满意的效果,乳房的外形得到了保持。术后随访最短4个月,最长26个月(平均13个月),无1例复发。结论荷包缝合加局部皮瓣转移是修复Paget病乳头乳晕部切除后皮肤软组织缺损的一种美观实用的方法。

Objective To explore an ideal reconstruction method for breast Paget＇s disease after excision of nipple area and the surrounding areola tissue. Methods 5 cases of early-stage breast Paget＇s disease were selected. The affected nipple and the surrounding areola tissue were excised and the defect was immediately reconstructed by the flap with the surrounding tissue with a subcutaneous pedicle from the lower part of the breast. The repair was finished by purse-string suture. Results The operation outcome is very good. The outer appearance and shape of the breast are preserved very well. The 5 patients had been followed up for 4 to 26 months （mean 13 months） and no recurrence of the Paget＇s disease was found. Conclusion Purse-string suture and local flap transfer is an aesthetic and pragmatic way to reconstruct the breast defect after excision of nipple and the surrounding areola tissue in patients with the Paget ＇s disease.