Comparative Analysis Of The Clinical Effects Of Latissimus Dorsi And Rectus Abdominis Musculocutaneous Flaps In The Treatment Of Radiation-induced Ulcer Of Chest Wall After Breast Cancer Surgery

Objective To study the comparative analysis of the curative effect of rectus abdominis myocutaneous flap and latissimus dorsi myocutaneous flap in the treatment of radiation ulcer of chest wall after breast cancer surgery,and to provide reference for clinical applicationMethods A total of 15 inpatients with department of burn and plastic surgery in the first affiliated hospital of guangxi medical university from October 2008 to October 2018 were collected,All the 15 patients had radiation ulcer on chest wall after radical mastectomy,According to the source of the flap,7 cases in group A were treated with rectus abdominis myocutaneous flap and 8 cases in group B with latissimus dorsi myocutaneous flap,The age,wound area,the time from the last radiotherapy to the occurrence of ulcer,postoperative hospitalization days,wound healing grade,and postoperative follow-up(ulcer recurrence rate)of the patients in the two groups were analyzed.Finally,the effects of the two methods are analyzedResults The mean healing time of 7 patients in group A was 24.1±10.4 days,Primary healing was not achieved in 5 patients,There was a case of distal flap partial necrosis,The wound was closed after debridement and partial flap transfer.The other 4 cases of local marginal necrosis were treated by dressing change,and the wound healed by itself.The mean healing time of 8 patients in group B was 13.8±3.2 days,Primary healing was not achieved in 1 patients,two groups of skin flap primary healing rate comparison,The difference was statistically significant(P=0.041<0.05)Conclusion The first-stage healing rate of latissimus dorsi musculocutaneous flap in the repair of chest wall radioactive ulcer was significantly higher than the rectus abdominis musculocutaneous flap,It can significantly shorten the postoperative hospitalization time.Both of them had good long-term curative effect and no recurrence of ulcer.Latissimus dorsi(LD)flap is preferred when both of the two surgical methods are available.When latissimus dorsi(LD)flap is not feasible or has contraindication,rectus abdominis flap is also a good alternative.