The application of a modified random flap in breast cancer patients after surgery and radiation
The application of a modified random flap in breast cancer patients after surgery and radiation
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DOI：
10.1016/j.asjsur.2019.11.008
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发表时间：
2020
影响因子：
3.5
通讯作者：
Shuyu Zhang
中科院分区：
文献类型：
--
作者：
Daojiang Yu;Wu Cai;Lu An;Yahui Feng;Jianping Cao;Shuyu Zhang
Background: Although musculocutaneous pedicle flaps are the first choice to repair radiation-induced ulcers on the chest wall, random flap is a commonly used flap for patients with poor health conditions. The limitation of length-to-width ratio influence the application of random flap. There are few studies about the blood supply compensatory changes in different distance near radiated ulcer center, some of which are relatively unpaired areas and appropriated donor areas for flap. This study aims to demonstrate the compensatory changes and design an modified and simple random flap, which break the conventional length-to-width ratio and can be operated easily with minimal injury..Methods: Dilation of choked vessels and angiogenesis were studied using enhanced computed tomography and vascular three-dimensional reconstruction in 20 patients. 7 patients were reviewed, which obtained simple and good reconstruction using the extended length-to-width ratio random flaps..Results: Obvious compensatory changes were found in the blood vessels surrounding ulcers, and there was a significant increase in the number of vessels beyond 3 cm away from the ulcer. All the flaps in the 7 patients survived satisfactorily with no complications..Conclusion: The modified random flaps break the conventional limitation of length-to-width ratio, which designed on the base of vessel compensatory changes. The modified flap is a good alternative to repair chest radiation-induced ulcer for patient who is contraindicated for conventional musculocutaneous flap.
