Effects of dextran-40 on flap viability after modified radical mastectomy |
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Authors: | Baris Dogu Yildiz Barlas Sulu |
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Affiliation: | 1.Department of Surgery, Ankara Numune Training Hospital, Ankara;;2.Kafkas University Faculty of Medicine, General Surgery, Kars, Turkey |
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Abstract: | BACKGROUND:Postoperative management of patients after modified radical mastectomy has evolved over the past decades. In the early postoperative period, wound complication rates were reported to be as high as 60%. Flap necrosis after modified radical mastectomy is a common problem encountered by surgeons. Various treatment strategies have been proposed in the literature but none have addressed the use of dextran-40.OBJECTIVE:To determine whether dextran-40 infusion improves skin flap viability after modified radical mastectomy.METHODS:Twenty-eight patients who underwent modified radical mastectomy were randomly assigned to receive dextran-40 or no dextran-40 intraoperatively after flap dissection. Patients were followed prospectively over a five-year period in a community hospital. The incidence of postmastectomy skin flap necrosis and prognosis of the necrotic area after dextran-40 infusion was observed.RESULTS:Flap necrosis was observed in five (17.8%) patients. Hypertension and diabetes mellitus were found to be risk factors for the development of flap necrosis (P<0.05). Flap thickness and tension on the flaps were found to be related to flap necrosis. Six of seven patients with flap perfusion problems (ecchymosis or necrosis) underwent dextran-40 treatment and healed without graft replacement.CONCLUSIONS:Dextran-40 treatment did not affect development of flap necrosis. However, if necrosis had already developed, the necrotic area of the skin flaps improved with dextran-40 treatment. |
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Keywords: | Breast cancer Breast surgery Flap circulation Flap surgery Mastectomy Resection Skin flap |
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