楔形真皮瓣塑形矫正乳头内陷21例

Correction of the inverted nipple by using deepithelialized wedge-shaped dermis flaps in 21 patients

目的探讨Ⅱ、Ⅲ型乳头内陷合并近乳晕区包块的手术治疗方法。方法 2010年8月至2013年1月对21例Ⅱ、Ⅲ型乳头内陷合并近乳晕区包块患者行包块切除术的同时行楔形真皮瓣乳头内陷矫正术。根据乳腺包块位置与乳头连线方向设计一个以乳晕侧为蒂的去表皮楔形真皮瓣,包块切除后皮瓣卷起内翻旋转固定于乳头基部以支撑乳头,并作荷包缝合塑形乳头颈部防止乳头回缩。结果用该矫正术治疗21例、21个乳头,术后乳头血运良好,外形满意。随诊6个月,感觉、勃起正常,瘢痕不明显。其中2例Ⅲ型乳头内陷术后出现轻度回缩,但比术前明显改善,患者未要求二次修复。结论该术式操作简单有效,同时解决了乳腺包块、乳头内陷,以及乳头内陷引发包块再发的隐患,针对乳头内陷合并乳腺包块人群值得推广。

Objective To explore a new surgery for gradeⅡandⅢinverted nipples with a mass near the areola in the breast. Methods Twenty-one patients who had gradeⅡorⅢinverted nipples with a mass near the areola in the breast were treated from October 2010 to January 2013 as followed：a deepithelialized wedge-shaped dermis flap connected to the areola was designed between the mass in breast and areola. After the mass was removed and the shortened lactiferous ducts and fibrous bands beneath the nipple were released, the flap was rolled up and put into the nipple as supporting tissues. Purse string suture was performed in case of the nipple retracting. Results The appearances of the 21 nipples were satisfactory. There was no decreasing sensation of the nipple and incision scar was indistinct after 6 months＇ follow-up. Two of the gradeⅢnipples showed slight retraction but was much better than the shape before operation. And the patients did not ask for a second operation. Conclusions There are various kinds of surgical procedure for nipple inversion. Choosing the one that fits the patient is very important. This kind of surgery corrects inverted nipples and removes the masses and the threat caused by the nipple inversion at the same time. Aimed at patients with gradeⅡandⅢinverted nipple and a mass in the breast, it is worth popularizing with its easy performance and satisfying outcome.