2种负压引流方式对聚丙烯酰胺水凝胶注射式隆胸取出术后切口不愈合效果的对比研究

Comparative study on the effects of refractory wound after breast polyacrylamide hydrogel removing operations of the two drainage ways

目的:前瞻性、完全随机对比研究两种负压引流方式在聚丙烯酰胺水凝胶注射式隆胸取出术后切口愈合效果、住院时间以及住院费用。方法:采用完全随机方法,将2004年12月至2009年12月拟手术的聚丙烯酰胺水凝胶隆胸取出术后切口不愈合的40例患者54侧乳房分成2组,2组均于乳晕或乳房下皱襞切开皮肤,直达术腔,在术中尽可能取出残余的聚丙烯酰胺水凝胶后,A组(远位引流组)于乳房下皱襞下方约5cm处切开皮肤约1.5cm,在腹壁肌肉内潜行分离至术腔,置入负压引流管;B组(原位引流组)于原切口置入负压引流管。结果:乳房外形扁平,手感柔软,无包块硬结。2组的切口一期愈合率、住院时间以及住院费用均有显著性差异。结论:远位引流方式相较原位引流方式临床效果更好,值得在临床上推广应用。

Objective：To observe and compare the wound healing effects,the time and costs of hospitalization of the two drainage ways in the breast polyacrylamide hydrogel removing operations by a prospective randomized controlled approach.Methods：From December 2004 to December 2009,a total of 54 breast-side of 40 patients,whose incision were not healing after breast polyacrylamide hydrogel removing operations,were divided into two groups.Both gorups＇skin incision were on the areola or inframammary crease.In the case of removing the polyacrylamide hydrogel during the operation as much as possible,a new incision,approximately 1.5cm,was produced below the inframammary crease approximately 5cm,the negative drainage tube was inserted into the new incision in the A group（distal drainage way）,While the negative drainage tube was inserted into the original incision in B group（In-situ drainage way）.Results：The breast appearance was flat and thin,the texture was soft and there was no mass or sclerosis.There were significant differences between the two methods in primary healing,the time and costs of hospitalization.Conclusion：The clinical effect of the distal drainage way is better than the clinical effect of the In-situ drainage way,and it deserves to apply in clinical practice.