箭式皮瓣法乳头再造术：长时间随访及效果评价

Nipple reconstruction with arrow-typed flap： long-term follow up and effective evaluation

目的 评价箭式皮瓣乳头再造的手术效果及其持久性.方法 对78例患者行回顾性研究,通过对再造乳头大小,局部皮瓣并发症发生率,切口愈合情况的长期随访来进行手术评价.结果 78例患者接受3个月以上随访,其中73例随访至6个月以上,62例随访至12个月以上,47例随访至24个月以上.再造乳头的高度和直径在术后3、6、12、24个月以上均存在不同程度地回缩.切口愈合不良者4例（5.1%）,切口裂开者3例（3.8%）,均经二次清创缝合后痊愈.所有患者均无局部及全部皮瓣坏死的情况发生,其中2例患者术后出现皮瓣部分淤血（2.6%）,术后5d未经处理自行消退.结论 箭式皮瓣易于设计,手术操作简单,效果可靠,术后并发症发生率较低,适合于各种乳房再造患者进行乳头再造.

Objective To evaluate the surgical outcomes and the long term results of nipple reconstruction using the arrow-typed flap. Methods A retrospective study＂ was performed on 78 patients. The operative results were evaluated through long-term follow up for the size of reconstructed nipple, the incidence rate of local flap complications and wound healing. Results Among 78 patients who received 3 months follow up, 73 were followed up for more than 6 months, 62 for more than 12 months, and 47 for more than 24 months. The height and diameter of the reconstructed nipples retracted at 3, 6, 12 and 24 months postoperatively. The delayed healing and disruption of wound occurred in 4 （5.1% ） and 3 （3.8%） patients respectively, which were cured after secondary wound debridement. All patients were without partial or total flap necrosis excepl for two with partial eongestion which were regressed at 5 days without any treatments. Conclusion Arrow-typed flap is a proper candidate for nipple reshaping after various breast reconstructions with these advantages, like easy design, simple procedure, stable efficacy and fewer complications.