乳腺癌根治术后皮瓣坏死的原因分析及预防

目的：探讨乳腺癌术后皮瓣坏死的原因及预防措施。方法：对176例女性乳腺癌手术患者的临床资料进行总结,分析不同年龄、手术方式、皮瓣厚度、皮瓣张力、皮瓣应用肾上腺素、术中应用电刀、术后应用加压包扎等因素对术后皮瓣坏死的影响。结果：176例女性乳腺癌手术患者中,术后皮瓣坏死38例,占21.59%。厚皮瓣者、低张力皮瓣者的皮瓣坏死发生率分别低于薄皮瓣者和高张力皮瓣者,差异有统计学意义。结论：皮瓣薄、皮瓣张力高是乳腺癌术后皮瓣坏死的主要原因,预防乳腺癌根治性手术后皮瓣坏死的关键原则是保证皮瓣血供。

Study on Cause of Skin Flap Necrosis after Radical Operation and the Preventive Measures of Carcinoma of Breast

Objective： To study the cause of the skin flap necrosis after radical operation for breast carcinoma. Methods： Reviewed and analyzed 176 patients with the breast cancer surgical treatment. Studied the relationship between the thickness of the skin flap, tension of the skin flap, and the necrosis of the skin flap. Results： The results showed that 38 case suffered from skin flap necrosis. The incidence of the flap necrosis in the thick skin flap group was lower than that in the thin skin flap group. The incidence of the flap necrosis in the high flap tension group was higher than that in the low tension group. Conclusion： This study suggests that the key of the prevention of skin flap necrosis is proper thickness and lower tension of the skin flap to ensure blood supply.