岛状背阔肌肌皮瓣乳房再造加腋前皱襞重建术的护理配合

Cooperation of reconstruction of breast and anterior axillary fold with island latissimns dorsi mnsculocutaneons flap

目的探讨乳腺癌根治术后Ⅱ期应用岛状背阔肌肌皮瓣加乳房假体行乳房再造术及腋前皱襞重建手术的护理配合。方法回顾性总结13例乳腺癌根治术后1—4年胸壁严重缺损患者行Ⅱ期岛状背阔肌肌皮瓣加乳房假体行乳房再造术及腋前皱襞重建的手术配合，包括术前人员、器械、物品及病人的准备，术中护士的配合方法。结果13例手术均获得成功，未发生由于器械或配合不良耽误手术，术中、术后皮瓣成活，切口无感染、均Ⅰ期愈合，无并发症发生，乳房外形良好，患者满意。结论术前物品准备充分及做好心理护理，取得患者的最佳配合；术中熟练的手术配合技巧是手术顺利完成的重要保证。

Objective To study nursing cooperation of second-stage reconstruction of breast and anterior axiUary fold with island latissimus dorsi musculocutaneous flap after Radical Mastectomy. Methods Thirteen patients with severe defect of thoracic wall underwent second-stage reconstruction of breast and anterior axillary fold with island latissimus dorsi musculocutaneous flap and breast implants 1 -4 years after the Radical Mastectomy for breast cancer. The nursing cooperation including preoperative preparation of staffs, surgical instruments, and articles, and methods of intraoperative nursing cooperation were retrospectively analyzed. Results Procedure success was gained in all 13 cases, without operation being delayed because of surgical instruments or poor cooperation. Flaps survived intraoperatively and postoperatively. Primary healing of incision without any infection was observed for all patients. Satisfactory mammary contour was achieved for all patients uneventfully with absence of any complications. Conclusions Careful preoperative preparation of articles and psychological nursing to gain best cooperation of the patients, and skilled intraoperative nursing cooperation are essential for procedure success.