Publication: Origin and countermeasure for common skin flap complications after radical operation for breast cancer
Date
2006
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
Objective: To discuss the various factors which cause the common skin flap complications after radical operation
for breast cancer
Methods: Two hundred sixteen patients with T1-3N0-1M0 breast cancer underwent radical surgery at The Cancer
Hospital of Xingtai City, China during 1995-2003. Patey mastectomy was performed in majority of patients. Skin
flaps were dissected using scalpel after injecting adrenaline containing saline into subcutaneous tissue. Diathermy
was used only to stop bleeding vessels. A subset of patients who developed abnormal vascularity of skin flaps,
seroma collection and flap necrosis was analyzed. Pressure garment and suction drains were used routinely. Flap
necrosis < 3cm2 was allowed to heal with secondary intention whereas larger defects were skin grafted.
Results: In 56 patients, flap associated complications were noted. Abnormal vascularity, flap necrosis and seroma
collection were absorbed in 34 (15.7%), 13 (6%) and 9 (4.2%) patients, respectively. Eight patients (3.7%) required
skin grafting. All patients were discharged with full recovery.
Conclusion: To minimize the skin flap complications after radical surgery for breast cancer, lesser use of cautery,
injection of adrenaline containing solution into subcutaneous tissue, routine use of suction drains and application of
pressure garment may be recommended.
Key Words: Modified radical mastectomy; seroma