根治隆乳后难愈性瘘道的新方法研究

目的 探讨根治隆乳后难愈性瘘道的新方法,以期提高愈合有效率.方法 选择2013年1月至2016年2月武汉市诠美医学美容门诊收治的注射隆乳术后胸腹壁内聚丙烯酰胺水凝胶(PAAG)混合物移位,造成胸腹壁广泛瘘道的患者178例,将其分为观察组和对照组,每组89例.观察组在清除瘘道后,进一步采用肌膜组织瓣的新设计治疗乳房内瘘道;对照组采取单纯清洗刮去残腔.观察术后创伤愈合面积比例及有效性.结果 PAAG在胸腹壁间隙广泛分布,形成乳腺下、腋窝、胸腹壁瘘道连通.2周时,观察组患者胸腹壁病变面积缩小80％,与对照组病变面积缩小45％比较差异有统计学意义(P＜0.01).4周时,观察组胸腹壁病变面积缩小95％,而对照组为71％,两组比较差异有统计学意义(P＜0.05).结论 乳房内PAAG混合物移位所形成的胸腹壁连通的慢性瘘道是造成胸腹壁内流动性包块与巨大空腔的主要原因,局部肌膜组织瓣可明显促进胸腹壁瘘道愈合.

A new method for the treatment of refractory fistula after breast augmentation

Objective To explore a new surgical method for the treatment of refractory fistula after breast augmentation and to improve patients healing efficiently.Methods This paper had collected two groups,a total of 178 cases of injected breast augmentation,who had shown the polyacrylamide hydrogel(PAAG)mixture shift,and caused abdominal fistula.Among them,89 cases further adopt new design in the treatment of fistula by using breast muscle membrane tissue flap and improve the effect of fistula treatment after the removal of fistula.And the other 89 cases were token the pure clean the cavity away caused by the abnormal material shift into the chest and abdominal wall.Results It was observed that PAAG widely distributed in the chest and abdominal wall and formatted the fistula connected mammary gland,axillary,chest abdominal wall.The area of lesions lacuna shrink by 80％ for the group used tissue flap after 2 weeks,but those not with tissue flap shrink by 45％(P＜0.01).At 4th week,all the patients of flap group achieved tissue healed,while the completely heal ratio of control group was only 73％.Compared two groups of healing rate,the group with tissue flap was obviously better than ones only with surgical method.Conclusion It suggests that main reasons for the liquidity bag and huge cavity are PAAG mixture shift into thoracic and abdominal wall and formed chronic fistula and connected the chest and abdominal wall.Local muscle membrane tissue flap can obviously promote the chest and abdominal wall fistula healing.