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目的探讨乳腺癌根治术中不同皮瓣处理方法对术后皮下积液及切口皮缘坏死的影响。方法回顾性分析某院2003～2009年行乳癌根治术120例患者的临床资料,分析不同皮瓣处理方式对术后皮下积液及切口皮缘坏死情况的影响。结果采用大刀片游离皮瓣组的皮下积液及皮瓣坏死率均明显低于电刀分离法组(P﹤0.05);U型铆钉式缝合组和皮瓣戳孔加压包扎组的皮下积液和皮瓣坏死率均低于皮下置管负压吸引组(P﹤0.05);而U型铆钉式缝合组的皮下积液高于皮瓣戳孔加压包扎组(P﹥0.05),但U型铆钉式缝合组的皮瓣坏死率却低于皮瓣戳孔加压包扎组,但差异无统计学意义(P﹥0.05)。结论大刀片分离皮瓣及皮瓣戳孔加压包扎的术式能有效地减少术后皮下积液和皮瓣坏死的发生率。
Objective To investigate the effects of different skin flap treatment methods on subcutaneous effusion and incision necrosis after radical mastectomy for breast cancer. Methods The clinical data of 120 patients undergoing radical mastectomy from 2003 to 2009 in a hospital were retrospectively analyzed. The effects of different skin flap treatments on subcutaneous effusion and incision necrosis were analyzed. Results The subcutaneous effusion and flap necrosis rate of the large flap free flap group were significantly lower than that of the electro-knife separation group (P <0.05). The subcutaneous product of the U-shaped rivet-type suture group and the flap puncture hole compression bandaging group (P <0.05). However, the subcutaneous effusion of the U-shaped rivet-type suture group was higher than that of the pressure-banding group (P> 0.05) However, the necrosis rate of the U-shaped rivet-type suture group was lower than that of the pressure-sensitive bandaging group of the puncture hole of the flap, but the difference was not statistically significant (P> 0.05). Conclusion The procedure of compressing and bandaging the flap and the puncture holes of the flap can effectively reduce the incidence of postoperative subcutaneous effusion and flap necrosis.