Application Of Surrounding Tissue Flap In Repairation Of The Local Breast Conserving Surgery

Objective: To evaluate the application of surrounding tissue flap about repairing local defect in breast conserving surgery. By cosmetic grade, objective and subjective satisfaction surveys, complications, patients were followed up to explore the safety of surrounding tissue flap, cosmetic and clinical application value.Methods: Clinical data of 60 breast cancer patients who received early treatments from august 2011 to July 2014 in the Second Affiliated Hospital of Nanchang University were collected, and 30 patients who received breast-conserving surgery, and 30 patients who received surrounding tissue flap breast-conserving surgery. It was confirmed the invasive cancer by organization. The breast incisions was cut from breast and armpit in all breast-conserving surgery. The breast surgery incision and axillary wrinkles arc incision were designed based on the location and size of tumor. Local expanded resection was used to obtain the negative pathological margin. Gland stump was sutured directly in breast-conserving surgery. The breast plastic surgery was applied in repairing remnant cavity in breast-conserving surgery by breast-conserving tissue flap transferred tissue group.The main methods as follows:1. Volume displacement techniques: pedicle flap of breast tissue, Suitable for direct suturing was difficult. Fully free the breast tissue between subcutaneous fat layer and the pectoralis major fascia.2. Volume replacement techniques:(1) The way of Lateral thoracic axillary fat tissue flap is suitable for lateral section defect of breast, lip of free latissimus dorsal muscular, and fill suture reelingly after fat fascial of thoraeotomy was organized.(2)Inframammary adipofascial flap. It is suitable for repairing lower quadrant of breast,forming a tunnel in free fat-gland space, filling in the defect gland area with free sheath of rectus fat fascial flap through the tunnel upward. Analyzing the complication cases about wound dropsy, infection, tissue necrosis after surgery,having radiation treatment, chemotherapy, targeted therapy, endocrine therapy andaccessory adjuvant treatment according anti-cancer association. Operation score was measured by SOMA_LNET of European cancer treatment and study group after six month. Objective evaluation and subjective satisfaction surgery were assessed by ministry of public health. Analyzing the statistical information..Result: Comparing the clinical effect of traditional breast-conserving surgery and breast-conserving tissue flap surgery. The result was strongly different in appear symmetrical, smooth degree, skin effect, nipple longitudinal and transverse distance,composite score and wound drops. But there have not restrict difference in skin color,incision scar, bleeding and hematoncus, wound infection, wound disruption, upper limb edema situation, and so on.Conclusion: The application of tissue flap transfer operation is not only safe in tumor pathology and provide more trustworthy negative pathological margin, but also can improve the cosmetic effect of breast-conserving surgery. Shaping the tissue around the wound into tissue flap, filling and fixing discontinuously the defect through rotation and crispation after surgery,to restore breast deletion in appearance.This operation is transferring and organizing independently, it is easy to operate and will not have rejection. Furthermore,it will improve the patient’s life quality largely.It is a better improved surgery procedure definitively.