Platysma muscle-cervical fascia-sternocleidomastoid muscle (PCS) flap for parotidectomy.

BACKGROUND: Parotidectomy is useful in the treatment of benign and malignant neoplasms of the parotid gland, but often leads to sequelae of facial deformity and Frey's syndrome. This paper presents a retrospective review of parotidectomy results in 21 consecutive patients treated with either traditional techniques or with the rotation and advancement of combined platysma muscle-cervical fascia-sternocleidomastoid flap (PCS). METHODS: The surgical procedures utilized for removal and reconstruction are described. Information on appearance and function was obtained by analysis of hospital and office records and telephone questionnaire for patients with and without the flap. RESULTS: Of the 21 patients eligible for this study, only 9 of 10 patients with the PCS flap and 10 of 11 patients without the flap provided sufficient data for analysis. In the flap group all 9 patients either noted a mild fullness on the operated side or no difference between sides. In the nonflap group, 4 patients felt they had a moderate depression, 2 patients noted a mild depression, and 4 patients noted no difference between sides. Frey's syndrome was classified as mild in 2 patients in the PCS group, whereas in the nonflap group, 4 patients thought it was mild and 1, severe. Complications were rare in either group. CONCLUSION: The PCS flap prevents deformity and contributes to patient satisfaction following parotidectomy. The flap helps to prevent Frey's syndrome and is not associated with an increase in postoperative complications. The flap is recommended following removal of nonrecurrent or low-grade malignant parotid tumors.     

Prophylaxis against Frey's syndrome in parotid surgery

In 1990 the authors reported their preliminary study of the prevention of Frey's syndrome in 55 patients utilizing a superficial musculoaponeurotic system (SMAS) flap in parotid gland surgery. During the past 10 years, numerous studies have supported their original thesis that interposition of living tissue between the resected gland bed and the skin could prevent the development of this complication. The authors have expanded their own patient population and now consider this a definitive study on the prevention of Frey's syndrome. A total of 160 patients are presented with a follow-up period of 5 to 22 years. All patients underwent subtotal or total parotidectomy performed by one of the authors. A history was acquired and testing for Frey's syndrome (Minor's starch iodine test) was performed. As a result of this approach, and in spite of the intensive search for it, no cases of Frey's syndrome were encountered. The hoped-for secondary benefit of preventing the postparotidectomy retromandibular depression was somewhat less satisfactory, although most patients remain satisfied with their appearance. The debilitating symptoms in Frey's syndrome, which is reported to have an incidence of 5% to 50% in the typical parotidectomy patient, can be avoided with thoughtful preoperative planning. The authors favor an aesthetic incision followed by the development of an SMAS flap. The parotidectomy is then performed using the surgeon's preferred technique. The SMAS flap is then placed into the bed of the resected parotid gland. This institutes a protective tissue barrier guarding against the aberrant anastomotic communication between the postganglionic secretomotor fibers intended for the parotid gland, and the now adjacent sweat glands. Their patient population is large enough to provide significant evidence that Frey's syndrome can be prevented, compared with a meta-analysis of parotid patients in multiple other studies in the literature. Assuming the patient's history and pathology does not preclude its use, the SMAS flap should be considered the standard of care for preventing Frey's syndrome in the postparotidectomy patient. If the SMAS flap is not available, a temporoparietal fascial flap has proved to be a good alternative.     

Surgical results of the intraoral removal of the submandibular gland

OBJECTIVES: Most patients with benign submandibular disorders have been treated surgically without difficulty via the transcervical approach. An alternative to the standard transcervical approach has been reported such as an intraoral approach. SUBJECTS AND METHODS: Retrospective chart review of the 77 patients with benign submandibular disorders. All patients underwent an excision of the submandibular gland via intraoral approach. RESULTS: Early postoperative complications developed in 74.0% of the temporary lingual sensory paresis followed by 70.1% of temporary limitation of tongue movement. However, these complications soon resolved in all patients spontaneously. Two cases of postoperative bleeding and 1 case of abscess formation were developed. Whereas late complications developed in 4 cases of residual salivary gland and abnormal sense of mouth floor and 1 case of gustatory sweating (Frey's) syndrome. CONCLUSION: The major advantages of this approach are no external scar, no injury to the marginal mandibular nerve. The disadvantage is a more difficult dissection to transcervical approach before proper expert, especially in the severe adhesion of salivary gland to surrounding tissue.     

带蒂胸锁乳突肌肌瓣一期修复腮腺肿瘤术后缺损的疗效

目的通过与直接拉拢缝合比较,探讨带蒂胸锁乳突肌肌瓣修复腮腺肿瘤切除后缺损的疗效。方法回顾分析2002年1月-2010年4月,采用带蒂胸锁乳突肌肌瓣一期修复38例(肌瓣组)腮腺肿瘤切除后缺损患者的临床资料,与同期直接拉拢缝合修复的35例(对照组)患者进行比较。两组患者性别、年龄、病程、肿瘤类型及大小等一般资料比较,差异均无统计学意义(P<0.05),具有可比性。分析两组术后局部凹陷畸形、Frey综合征和腮腺瘘并发症发生情况。结果肌瓣组术后肌瓣均成活,创面Ⅰ期愈合;对照组切口均Ⅰ期愈合。术后两组患者均获随访,随访时间6～98个月。随访期间肿瘤均无复发。术后6个月两组患者面部凹陷畸形程度比较,差异有统计学意义(χ2=53.202,P=0.000)。肌瓣组术后发生1例(2.6%)腮腺瘘,1例(2.6%)Frey综合征;对照组分别为8例(22.8%)及20例(57.1%);两组并发症发生率比较差异均有统计学意义(P<0.05)。结论采用带蒂胸锁乳突肌肌瓣修复腮腺肿瘤切除后缺损,可预防术后局部凹陷畸形、Frey综合征和腮腺瘘并发症的发生。     

Frey's syndrome and parotidectomy flaps: A retrospective cohort study.

Gustatory sweating, also known as Frey's syndrome, is a recognized phenomenon after parotidectomy. The incidence of clinically significant gustatory sweating may be dependent on the thickness of the skin flap that is elevated at the time of surgery. Dissection in the subcutaneous level or the deeper sub-superficial musculoaponeurotic system level are 2 commonly used techniques in the operation. Twenty-eight patients were prospectively evaluated for Frey's syndrome after superficial parotidectomy. Thirteen patients underwent subcutaneous and 15 patients sub-superficial musculoaponeurotic system flap elevation. The overall incidence of gustatory sweating was determined, and a comparison of the two surgical techniques was assessed subjectively by patient interview-questionnaire and objectively evaluated with starch-iodine testing.     

Combined CMV prophylaxis improves outcome and reduces the risk for bronchiolitis obliterans syndrome (BOS) after lung transplantation

BACKGROUND: The benefit of cytomegalovirus (CMV) hyperimmune globuline in preventing CMV infection after lung transplantation still remains unclear. The aim of this study was to investigate the effect of combined prophylaxis using ganciclovir (GAN) and CMV hyperimmune globulin (CMV-IG) on CMV infection, CMV disease, survival and its role in preventing Bronchiolitis obliterans syndrome (BOS). METHODS: A consecutive series of 68 CMV high-risk lung transplant recipients (D+/R-, D+/R+), who had a minimum follow-up of 1 year posttransplant were analyzed. Thirty patients (44.1%) received single GAN prophylaxis for 3 months (control group) and 38 recipients (55.9%) received GAN together with CMV-IG 7 times during the first postoperative month (study group). Median follow-up was 16.5 months in the control and 23.8 months in the study group (P = 0.54). RESULTS: Five CMV-related deaths (16.7%) occurred in the control group (P = 0.014). Fifteen recipients suffered from CMV pneumonitis and three patients had CMV syndrome. In the control group, 13 recipients (43.3%) suffered from clinically manifested CMV disease compared to 5 (13.2%) in the study group (P = 0.007). Additionally, recipient survival was significantly better in the study group (P = 0.01). One year freedom from CMV affection was 52.1% in the control and 71.5% in the study group (P = 0.027). Three-year freedom from BOS was significantly higher in the study group (54.3% vs. 82%, P = 0.024). CONCLUSIONS: In CMV high risk patients, additional CMV-IG administration seems to be effective to reduce CMV-related morbidity and to avoid CMV-related mortality. Reduced incidence of BOS may result from improved CMV prevention, although randomized trials are warranted.     

改良肌皮瓣法结合眶隔固定术在眼袋整形中的临床效果

目的 探究在眼袋整形中应用改良肌皮瓣法+眶隔固定术的临床效果。方法 选取2022年 4月-2023年2月于我院接受眼袋整形术的100例患者作为研究对象，随机分为对照组和观察组，各50 例。对照组采用传统肌皮瓣法治疗，观察组采用改良肌皮瓣法+眶隔固定术治疗，比较两组临床疗 效、眼袋皮肤外观恢复正常时间以及并发症发生率。结果 观察组治疗总有效率高于对照组，差异有统 计学意义（ P ＜0.05）；观察组术并发症发生率低于对照组，差异有统计学意义（ P ＜0.05）；观察组眼袋 皮肤外观恢复正常时间短于对照组，差异有统计学意义（ P ＜0.05）。结论 改良肌皮瓣法+眶隔固定术应用 于眼袋整形术中效果理想，恢复时间短，且术后并发症发生率较低。     

Innovative technique to reduce incidence of Frey's syndrome after parotid surgery

Frey's syndrome was first described by Lucia Frey, a Polish neurologist in 1923. It is well accepted that it involves injury to the branches of the auriculotemporal nerve with subsequent aberrant regeneration. Due to this abnormal communication, the skin glands and vessels are always stimulated at the same time as eating and mastication, which results in symptoms such as flushing and sweating. The incidence of Frey's syndrome in the literature has been variously described from 6 to 96 per cent. We analyzed the chart of 18 patients who had parotidectomy from March 2002 to December 2009. All procedures were performed by a single surgeon at the same facility. A total of 16 superficial and three total parotidectomies were done; one patient had bilateral parotidectomy. Oxidized regenerated cellulose (Interceed) was used after 10 surgeries (study group) and no adjuvant was used after nine surgeries (control group). All of the surgeries were done using similar technique. All the patients were followed-up with for a period of about 6 months postoperatively. The absolute risk reduction associated with the placement of an Interceed was 11 per cent. The small number of cases (n = 19) and an empty cell limits statistical analysis (a Fisher's exact test revealed a P value of 0.44). Clearly the low number of procedures restricted the power to test these differences. The development of Frey's syndrome is a very disabling but under-reported complication. The placement of a temporary barrier like Interceed may help in the prevention of Frey's syndrome without increasing any complications.     

异种胶原蛋白基质与自体结缔组织移植瓣在牙周软组织增量效果的研究

目的 研究异种胶原蛋白基质与自体结缔组织移植瓣对牙周软组织增量效果的影响。方法 选取 2022年7月-2023年12月于我院行种植修复治疗或种植术后复查的80例牙周病患者为研究对象,采用随机 数字表法分为对照组和观察组,各40例。对照组采用自体结缔组织移植瓣,观察组采用异种胶原蛋白基 质与自体结缔组织移植瓣联合治疗,比较两组创面愈合时间、临床疗效、美观满意度、牙周健康指标[改 良龈沟出血指数（mBI）、改良菌斑指数（mPI）]以及并发症发生情况。结果 观察组创面愈合时间为 （14.01±2.10）d,短于对照组的（16.28±3.21）d（P ＜0.05）;观察组治疗总有效率为97.50%,高于对照 组的82.50%（P ＜0.05）;观察组美观满意度高于对照组（P ＜0.05）;观察组mBI、mPI均小于对照组,并 发症发生率低于对照组（P＜0.05）。结论 异种胶原蛋白基质与自体结缔组织移植瓣联合治疗可提高临床 疗效,降低并发症发生率,缩短创面愈合时间,改善牙周健康指标,提升患者美观满意度。     

Valacyclovir for cytomegalovirus prophylaxis reduces the risk of acute renal allograft rejection

BACKGROUND: Both oral ganciclovir and valacyclovir decrease the incidence of cytomegalovirus (CMV) disease after renal transplantation. Moreover, valacyclovir has been shown to reduce the risk of acute rejection. Our study was designed to compare the efficacy and safety of oral ganciclovir and valacyclovir in the prophylaxis of CMV disease after renal transplantation. METHODS: A total of 83 patients were prospectively randomized to 3-month treatment with oral ganciclovir (3 g/day, n=36, GAN) or oral valacyclovir (8 g/day, n=35, VAL). A control group (DEF, n=12) was managed by deferred therapy. RESULTS: No differences were found in demography, immunosuppression, or donor/recipient CMV serology. The 12-month incidence of CMV disease was 67% in the DEF group compared with 6% in the GAN group and 3% in the VAL group (P<0.001 GAN or VAL vs. DEF; P=0.575 GAN vs. VAL). The biopsy-confirmed acute rejection rate at 12 months was 12% in the VAL group compared with 34% in the GAN group (P=0.030) and 58% in the DEF group (P<0.001). The difference between the GAN and DEF groups was not significant (P=0.087). The average CMV-associated costs per patient were $3,072, $2,906, and $4,906 in the GAN, VAL, and DEF groups, respectively. CONCLUSIONS: Valacyclovir and oral ganciclovir are equally effective in the prevention of CMV disease after renal transplantation. Both regimens are cost-effective. Valacyclovir is associated with a significantly reduced risk of acute rejection compared with both ganciclovir prophylaxis and deferred therapy.     

保留乳头乳晕乳腺癌改良根治术后即刻扩展型背阔肌乳房再造术的临床应用

目的:探讨保留乳头乳晕乳腺癌改良根治术后即刻扩展型背阔肌乳房再造术的安全性与疗效。方法:回顾性分析蚌埠医学院第一附属医院肿瘤外科32例行保留乳头乳晕乳腺癌改良根治术后即刻扩展型背阔肌乳房再造术患者(观察组)和34例行传统乳腺癌改良根治术患者(对照组)临床资料,比较两组患者并发症、预后,并分析观察组重建乳房外形评分情况。结果:两组年龄、肿瘤大小、病理分期方面无统计学差异(均P0.05);观察组与对照组术后总并发症发生率差异无统计学意义(37.5%vs.32.4%,P0.05)。所有患者随访18~60个月,中位时间44个月,观察组局部复发2例,远处复发3例;对照组局部复发3例,远处转移3例,观察组与对照组3年无瘤生存率差异无统计学意义(87.5%vs.91.2%,P0.05)。观察组乳房外形评分优良率为90.6%。结论:保留乳头乳晕乳腺癌改良根治术后即刻扩展型背阔肌乳房再造术安全有效,重建的乳房外观满意,且不增加并发症与局部复发、远处转移风险。     

不同胆道重建方式治疗先天性胆管扩张症的疗效对比研究

目的比较肝管空肠Roux-Y吻合术、改良肝管空肠Roux-Y吻合术、肝管空肠Roux-Y吻合术+矩形瓣术3种胆道重建方式治疗先天性胆管扩张症的临床效果。 方法选择恩施土家族苗族自治州中心医院2010年10月至2013年7月收治的90例先天性胆管扩张症患者,随机分为A组（行肝管空肠Roux-Y吻合术）、B组（行改良肝管空肠Roux-Y吻合术）和C组（采取肝管空肠Roux-Y吻合术+矩形瓣术）,各30例。比较3组治疗总有效率、抗反流效果、手术时间、出血量、住院时间、近期并发症发生率,术后长期随访,评价3组患者的远期疗效及并发症总发生率。 结果B组与C组的治疗总有效率分别为93.3%和96.7%,优于A组的73.3%,差异有统计学意义（Z=10.881,P<0.01）。B组与C组反流性胆管炎分别为13.3%和10.0%,低于A组的36.7%,差异有统计学意义（χ²=7.917,P=0.019）。3组手术时间、出血量、住院时间的差异无统计学意义（F=0.795、2.217、2.919,P=0.454、0.115、0.059）。A、B、C组的近期并发症分别为26.7%（8/30）、20.0%（6/30）和13.3%（4/30）,差异无统计学意义（χ²=1.667,P=0.435）。随访时间1.5~4年,平均（2.8±1.2）年,C组远期并发症总发生率为13.3%（4/30）,显著低于A组的43.3%（13/30）、B组的40.0%（12/30）,差异有统计学意义（χ²=7.428,P=0.024）。 结论肝管空肠Roux-Y吻合术+矩形瓣术治疗先天性胆管扩张症具有良好抗反流作用且远期并发症少,效果理想。     

眶内侧骨膜折叠联合眼袋皮瓣法在治疗中老年皮肤及肌肉松弛膨出型的效果

目的 探究对面中部松弛合并眼袋患者应用眶隔折叠联合皮瓣法眼袋矫正术治疗的效果。 方法 选择2021年6月-2022年6月我院收治的82例中老年皮肤轮匝肌松弛型睑袋膨出患者为研究对 象,按随机数字表法分为传统组和改良组,每组41例。传统组采用皮瓣法眼袋矫正术治疗,改良组采用 眶隔折叠联合皮瓣法眼袋矫正术治疗,比较两组手术效果、治疗满意度及并发症发生情况。结果 改良 组治疗优良率为97.56%,高于传统组的85.37%（P ＜0.05）;改良组治疗满意度为92.68%,高于传统组的 73.17%（P ＜0.05）;改良组并发症发生率为2.44%,低于传统组的14.63%（P ＜0.05）。结论 对中老年皮 肤轮匝肌松弛型睑袋膨出患者应用眶隔折叠联合皮瓣法眼袋矫正术治疗的效果良好,且治疗后不良反应发 生几率较低,患者满意度较高,值得临床应用。     

The gracilis free flap for reconstruction of parotidectomy defects

Summary Total parotidectomy causes a significant postoperative concave deformity in the retromandibular, preauricular, and infra-auricular regions of the face; many patients are concerned about this defect. Frey's syndrome (gustatory sweating) is also a well-recognized postoperative entity following parotid surgery. The incidence of Frey's syndrome ranges from 10–90%, depending on the type and complexity of the investigation used to diagnose it [5, 11]. Numerous methods have been described to correct these problems. Patients requiring total parotidectomy were recently offered the option of immediate reconstruction of the contour defect with microvascular transfer of a tailored gracilis muscle flap. Four patients are included in this preliminary series; all are extremely satisfied with the postoperative result. The defect following total parotidectomy can be reconstructed immediately with gratifying cosmetic results, a hidden donor site scar, and to date no operative morbidity.     

Frey's syndrome.

Frey's syndrome occurs after parotid gland surgery or injury to the parotid gland and is characterized by gustatory sweating and erythema of the face upon mastication. The syndrome occurs in 50 to 60 per cent of all patients undergoing parotid surgery but the symptoms are only distressing to about 10 per cent of patients undergoing parotidectomy. A case of Frey's syndrome is reported The patient obtained good relief of symptoms with scopolamine cream and atropine cream. Other methods of therapy are discussed along with their limitations. Noninvasive therapy with topical anticholinergic creams is effective and seems appropriate in the control of gustatory sweating.     

Outcomes of immediate vertical rectus abdominis myocutaneous flap reconstruction for irradiated abdominoperineal resection defects

BACKGROUND: Perineal wound complications after chemoradiotherapy and abdominoperineal resection (APR) for anorectal cancer occur in up to 60% of patients, including perineal abscess and wound dehiscence. Vertical rectus abdominis myocutaneous (VRAM) flaps have been used in an attempt to reduce these complications by obliterating the noncollapsible dead space with vascularized tissue and closing the perineal skin defect with nonirradiated flap skin. Many surgeons are reluctant to use VRAM flaps unless primary closure is not possible. STUDY DESIGN: All patients who underwent chemoradiotherapy and APR during a 12-year period at the University of Texas MD Anderson Cancer Center were retrospectively reviewed. Patient, tumor, and treatment characteristics and surgical complications and outcomes were compared between patients who underwent VRAM flap reconstruction of wounds that could have been closed primarily (flap group, n = 35) and those who had primary closure of the perineal wound (control group, n = 76). RESULTS: Overall, there were no significant differences in the incidence of perineal wound complications between the groups; the flap group had a significantly lower incidence of perineal abscess (9% versus 37%, p = 0.002), major perineal wound dehiscence (9% versus 30%, p = 0.014), and drainage procedures required for perineal/pelvic fluid collections (3% versus 25%, p = 0.003) than the control group had. Despite flap harvest and the need for donor site closure in the flap group, there was no significant difference in abdominal wall complications between groups during the study's mean patient followup of 3.8 years. CONCLUSIONS: VRAM flap reconstruction of irradiated APR defects reduces major perineal wound complications without increasing early abdominal wall complications. Strong consideration should be given to immediate VRAM flap reconstruction after chemoradiation and APR.     

Complications of superficial parotidectomy versus extracapsular lumpectomy in the treatment of benign parotid lesions.

A total of 46 patients with benign parotid gland tumours have been operated upon between 1979 and 1989 in the Department of Otolaryngology at Leicester Royal Infirmary. Thirty-one were pleomorphic adenomas, six Warthin's tumours and nine miscellaneous tumours or tumour-like lesions. Extracapsular lumpectomy without facial nerve preparation was used in 31 cases (67%) and superficial parotidectomy in 15 cases (33%). One case of permanent partial facial palsy and one recurrence occurred in patients who underwent superficial parotidectomy. Frey's syndrome occurred in 40% of patients undergoing superficial parotidectomy. No permanent palsy, recurrence or Frey's syndrome occurred after extracapsular lumpectomy. These results suggest that extracapsular lumpectomy may reduce the morbidity rate in carefully selected patients.     

A retrospective review of the incidence of various complications in different delayed breast reconstruction methods

Background: Breast reconstruction is a common standard procedure in many centres after breast cancer surgery. The aim of the present study was to investigate and compare the incidence of various complications in different reconstruction methods. Method: Six hundred and eighty-five patients were retrospectively classified into five groups: (1) Deep inferior epigastric perforator flap (DIEP), (2) latissimus dorsi flap (LD), (3) lateral thoracodorsal flap (LTDF), (4) expander with secondary implant (EXP), and (5) direct implant (DI). Demographic and perioperative data, the incidence of complications, and follow-up data were collected. Results: There was a significant difference between groups regarding overall early complications (p?<?0.001). The DIEP group had the highest incidence of overall complications (50.0%) (p?<?0.05). DIEP also had the highest incidence of fat necrosis (18.3%), skin necrosis (22.1%), and incidence of reoperation for complications (26.9%) compared to the other reconstruction methods. In the entire group of patients, the overall incidence of late complications (occurring >30 days after surgery) that needed surgical corrections was 54.7%. The incidence of late complications was 46.2% for DIEP, 66.4% for LD, 74.8% for LTDF, 44.9% for EXP, and 62.9% for DI. The DIEP group had higher incidences of late local complications (fat necrosis, skin necrosis, haematoma, seroma, and wound rupture combined), and scars requiring treatment than the other reconstruction methods. Conclusion: Meticulous registration of incidence of different complications in five different breast reconstruction methods revealed high complication rates with all methods. The differences in incidence of complications were related to the operation method used. Based on these results, careful individual planning of a breast reconstruction is mandatory.     

腮腺肿瘤术后Frey综合征预防的初步研究

目的探索预防腮腺肿瘤术后Frey综合征发生的临床方法。方法将100例因腮腺肿瘤于2001年至2004年在我院接受腮腺浅叶或全腮腺切除术的患者分为研究组和对照组,每组各50例。研究组在腮腺及肿瘤切除术将结束时,在腮腺术床面神经各分支表面与皮瓣之间插入胶原蛋白片,作为隔离填充,阻止神经错位生长。对照组术中不植入隔离物,其他方面与研究组匹配。术后半年以上,用同一问卷收集患者资料,进行分析评价。结果随访时间为10～39个月,平均16个月。研究组Frey综合征发生率为20％（10／50）,对照组为60％（30／50）（X^2=15．04,P〈0．001）,术后颜面轮廓明显凹陷畸形的出现率两组分别为44％和80％（X^2=12．26,P〈0．001）。结论这种手术方式将Frey综合征的发生率由60％降至20％,为腮腺术后Frey综合征的预防提供了一种简单而有效的方法,同时患者术后颜面轮廓畸形也获得明显改善。     

���ٰ�����������Ƥ����ѡ���ٴ��о�

??Flap thickness selection in modified radical mastectomy??a clinical study ZHAI Bao-ping, LI Wen-tao, ZHANG Bin. Department of Breast Surgery, the People's Hospital of Henan Province, Zhengzhou 450003, China
Corresponding author??ZHAI Bao-ping, E-mail: zhaibaoping@163.com
Abstract Objective To explore the selection of flap thickness in modified radical mastectomy and reduce the incidence of postoperative complications. Methods The clinical data of 78 patients with breast cancer performed modified radical mastectomy between January 2008 and December 2008 in the Department of Breast Surgery, the People's Hospital of Henan Province were analyzed retrospectively. The patients were divided into C group (patients from January to June) and S group (patients from July to December). Intraoperative blood loss, operation time and incidence of postoperative complication between two groups were compared. Results Intraoperative blood loss, operation time, postoperative total drainage volume and the incidence of flap necrosis in the S group were lower than those in the C group (P??0.05). There was no significant difference on the incidence of subcutaneous fluid between two groups??P??0.522??. Conclusion Dissociating flap close to the lateral chest wall superficial fascia superficial fat layer can reduce the postoperative complications of radical mastectomy effectively.