Application Study Of Homemade Flap Rivets And Thick Drainage Tubes In Modified Radical Mastectomy For Breast Cancer

Objective(s):To evaluate the value of homemade gauze rivets suture fixation flap and thick drainage tube in modified radical mastectomy for breast cancer,to analyze the influencing factors of postoperative complications,and to provide some reference measures for the selection of flap suture fixation methods and drainage device in modified radical mastectomy.Methods: The clinical data of patients undergoing modified radical mastectomy for breast cancer with a preoperative pathological puncture or intraoperative frozen results suggestive of breast cancer were retrospectively collected and analyzed from October 2015 to October 2022 in the General surgery department in a Tertiary Hospital in Yunnan Province Including basic data(age,preoperative albumin level,whether they had hypertension,diabetes mellitus,whether they underwent preoperative neoadjuvant therapy),intraoperative conditions(operation time,intraoperative bleeding,number of axillary lymph node dissection),pathological data(pathological stage,axillary lymph node metastasis),postoperative complications(subcutaneous blood and fluid accumulation,skin flap necrosis,infection at the operation site),postoperative conditions(postoperative drainage tube removal time,postoperative hospitalization days).During the operation,the homemade gauze rivet is used to fix the free flap,and only place one axillary drainage tube.According to the different axillary drainage tubes,the group with disposable surgical gloves attached to the end of the F32 rigid thick drainage tube is defined as the observation group,and the conventional disposable negative pressure drainage ball group is defined as the control group.The SPSS 25.0 statistical software is applied to conduct an independent sample t-test or non-parametric test for quantitative data collected and a chi-square test or Fisher exact test for qualitative data to compare the differences between groups,analyze and compare the differences in the incidence of postoperative complications,drainage tube removal time and postoperative hospitalization days between the two groups,and explore the We also explored the factors associated with the occurrence of postoperative complications,prolonged drainage tube removal time and prolonged postoperative hospitalization days.Results:1.The difference in Subcutaneous effusion between the observation group and the control group was statistically significant(p<0.05),but the difference between the two groups was not statistically significant(p>0.05)in terms of whether the postoperative extubation time was prolonged and whether the postoperative hospital stay was prolonged.2.The difference between patients’ history of neoadjuvant therapy and the occurrence of subcutaneous effusion was statistically significant(p<0.05),but the differences between patients’ age,preoperative albumin level,operation time,blood loss,whether there were metastases in axillary lymph nodes,number of lymph node metastases,number of lymph node clearances,history of hypertension and diabetes,and pathological stage were not statistically significant(p>0.05).3.In addition to the statistically significant difference between the occurrence of subcutaneous effusion and prolonged extubation time,there was also a statistically significant difference between patients’ age and prolonged extubation time(p<0.05),but the differences between patients’ preoperative albumin level,operation time,blood loss,axillary lymph node metastasis,number of lymph node metastasis,number of lymph node dissection,history of hypertension,diabetes mellitus,preoperative neoadjuvant therapy,and pathological stage ware not statistically significant differences in the prolonged extubation time(p>0.05).4.There was a statistically significant difference between patients not only for subcutaneous fluid collection and prolonged postoperative hospital stay but also between operative time and prolonged postoperative hospital stay(p<0.05),but patients’ age,preoperative albumin level,blood loss,axillary lymph node metastasis,number of lymph node metastasis,number of lymph node dissection,history of hypertension,history of diabetes,history of preoperative neoadjuvant therapy,pathological stage were not statistically significant differences in prolonged postoperative hospital stay(p>0.05).Conclusion(s): 1.the use of homemade gauze rivet sutures to fix the free flap and a drainage device with a thick axillary drainage tube connected to disposable sterile surgical gloves during modified radical surgery has a low incidence of postoperative subcutaneous fluid accumulation in patients and does not prolong the time of extubation and postoperative hospital stay.2.Patients with a history of neoadjuvant treatment who undergo modified radical mastectomy have a high probability of postoperative subcutaneous effusion,and intraoperative attention should be paid to such patients to prevent the occurrence of postoperative subcutaneous effusion.3.for elderly patients with breast cancer undergoing modified radical surgery,the drainage tube removal time can be extended appropriately.4.In addition to the occurrence of postoperative complications,the duration of surgery is also an influential factor in the prolongation of postoperative hospital stay and ensures that the surgery is completed safely in the shortest possible time.