乳腺癌根治术预防皮缘坏死及积液40例的体会

目的探索乳腺癌根治手术中及术后避免皮瓣坏死及皮下积液的方法。方法对40例乳腺癌根治手术,采用皮下注射生理盐水和蒸馏水混合液,组织剪游离皮瓣并止血,同侧腋窝注射溶脂液,溶脂后结扎腋窝淋巴管,清除腋窝淋巴结;应用较细的硅胶管螺旋式剪侧孔,置于术野边缘一圈,距皮缘3 cm处缝皮瓣至胸壁,采取小负压持续吸引,免除胸带及皮外加压包扎。结果40例乳腺癌根治术,仅1例行皮瓣转移患者有少许皮瓣坏死外,其余均为一期愈合。结论乳腺癌根治术彻底止血、保护皮缘血供、术后有效引流、避免皮肤过度加压是预防了皮瓣坏死、皮下积液的有效措施。

Prevention of flap necrosis and seroma in radical mastectomy: report of 40 cases

Objective To find the way to prevent flap necrosis and seroma after radical mastectomy.Methods Forty patient received radical mastectomy by the following methods: 1.subcutaneous injections of the mixture of saline and distilled water;2.dissection of flaps and hemostasis by tissue scissors;3.liposuction of the axilla;4.application of smaller spiral silicone with side holes at the edge of the operative field;5.suture of the flap to the chest wall 3 cm away from skin margin;and 6.continuous suction under small...