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首页> 外文期刊>Journal of plastic, reconstructive & aesthetic surgery: JPRAS >Improving outcomes in microsurgical breast reconstruction: Lessons learnt from 406 consecutive DIEP/TRAM flaps performed by a single surgeon
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Improving outcomes in microsurgical breast reconstruction: Lessons learnt from 406 consecutive DIEP/TRAM flaps performed by a single surgeon

机译:改善显微外科乳房重建术的结果:由单名外科医生从406个连续的DIEP / TRAM皮瓣中吸取的教训

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摘要

Background Multiple preoperative, intraoperative and postoperative decisions can influence the outcome of microsurgical breast reconstruction. We have simplified the decision-making process by incorporating a number of algorithms into our microsurgical breast reconstruction practice and critically review our results in this study. Methods Prospectively maintained databases for all microsurgical breast reconstructions performed by a single surgeon over a nine-year period were examined to determine: patient demographics; operative details including flap choice, donor and recipient vessel selection; and, details of intraoperative and early postoperative (
机译:背景技术术前,术中和术后的多项决策可能会影响显微外科乳房重建的结果。通过将多种算法整合到我们的显微外科乳房重建实践中,我们简化了决策过程,并严格审查了本研究的结果。方法检查由一名外科医生在九年时间内进行的所有显微外科乳房再造术的前瞻性维护数据库,以确定:患者统计资料;操作细节,包括皮瓣选择,供体和受体血管选择;以及术中和术后早期(<6周)并发症的详细信息及其处理。结果在研究期间,对285例患者进行了406例连续皮瓣显微外科手术乳房再造术(单侧164例,双侧121例)。腹壁深部下动脉穿孔(DIEP)皮瓣(88%,n = 359)最常用,其次是肌肉保留腹直肌腹肌肌皮(MS-TRAM)皮瓣(11%,n = 44)和筋膜保留TRAM (FS-TRAM)襟翼(0.7%,n = 3)。一百一十一(48%)个DIEP瓣基于单个穿孔器,而188个(52%)具有多个穿孔器。乳内(IM)动脉和静脉用作99%(n = 403)皮瓣的接受血管。皮瓣的11.8%(n = 48)需要第二次静脉吻合。部分瓣失败发生在九个(2.2%)皮瓣中,而总瓣失败发生在两个瓣中(0.5%)。最小随访时间为三个月。结论将许多算法结合到我们的实践中使我们能够简化涉及显微外科乳房重建的决策过程,并始终如一地获得成功的手术结果。

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