乳腺癌根治术后皮瓣愈合的临床观察

目的：探讨乳腺癌根治术采用切H方式对皮瓣愈合的影响。方法：对380例乳腺癌根治术患者的临床资料进行回顾性分析。380例患者分为A、B组，A组167例患者采用纵切口，B组213例采用横切口，分析不同的手术切口方式对于皮瓣坏死的发生率及皮瓣愈合的影响。结果：A组167例中皮瓣坏死71例（42．5％），B组213例中皮瓣坏死12例（5．6％）。横切口皮瓣坏死明显低于纵切口（P〈0．05）。结论：乳腺癌根治术行纵切口的皮肤张力较大、血供障碍是皮瓣坏死发生率较高的主要原因；而横切口皮肤由于纵向张力的缓冲，皮肤张力减低，皮瓣血运良好，切口Ⅰ期愈合率明显提高。

Clinical observation of skin flap healing after radical operation with breast cancer

Objective:To investigation the effects of incision and skin flap healing after radical operation of breast cancer. Methods:A retrospective analysis of clinic data of 380 cases of radical operation of breast cancer. All cases were divided into two groups, group A 167 cases adopted vertical cut, group B 213 cases adopted transverse cut, and the effects of different cut means for skin flap necrosis and skin flap healing were analysed. Results:There were 71 cases with skin flap necrosis in group A (71/167, 42. 5%) , and 12 in group B (12/213, 5. 6%), with significant diffeerence (P <0. 05) between the two groups. Conclusions:Greater skin pulling force and dysfuaction of blood supply of vertical incision in this operation may be the inportant cause of skin flap necrosis. But in transverse incision, the skin pulling force decreases and blood supply of skin flap runs well, so that the stage one healing rate of incision is raise.