摘要
目的:参照乳头内陷修复的各种手术方法,通过对酒井法的技术性改良,探索一种兼顾功能和形态的更加完善的手术方法。方法:于2001-01/2003-01选择横滨市立大学病院及横滨整形外科收治先天性乳头内陷的女性患者33例为研究对象。单侧28例,双侧5例。采用改良酒井法手术,牵引出内陷乳头后,在乳腺窦的旁边描圆,这将是术后乳头顶部的外圆,然后在乳头基底部描画直径为2.5～3.0cm的同心圆,这是预定Z型皮瓣的纵轴,在乳头顶部对角设计两个皮瓣。直视下沿乳腺导管分离并彻底切除乳腺导管之间的纤维束、上至乳头顶部下至胸壁,并在必要时切断一两根特别短缩的乳腺导管,特别注意保存大部分的乳腺导管及血管,然后在乳晕区内切断乳头肌。按Z型皮瓣成形术作皮内缝合,制造乳头颈部,并保持乳头形态。结果:纳入患者33例,均进入结果分析。术后随访1年以上,均无再复发,瘢痕不明显,与对侧乳头基本对称,患者满意。结论:改良酒井法对乳头内陷的矫正能够兼顾乳头功能和外形。
AIM： To search for a more effective surgical procedure to give consideration to function and appearance of nipple by modifying Sakai approach according to various inverted nipple plasty.
METHODS： A total of 33 patients were selected from the Department of Plastic Surgery, Yokohama University Hospital between January 2001 and January 2003, including 28 cases of unilateral nipple inversion and 5 cases of bilateral nipple inversion. Sakai approach was adopted, and circles were drawn in the periphery of mammary gland sinus after the pulling out of inverted nipples, which were the out-circles in top nipples after operation, A cocenric citcle with the diameter of 2,5-3.0 cm was drawn in the basilar part of nipple, which was prepared as the longitudinal axis of ＂Z＂ flaps. Two flaps were designed at opposite angles of the top of nipples, The fiber bundles between ducts of mammary gland were completely separated along the ducts under direct watching, which were cut from as high as the top nipple to as low as the chest wall. One or two special shortened ducts of mammary gland were cut when necessary with most of them as well as vessels reserved, and the papillary muscles were cut off inside the nipple surrounding, lntradermic suture was conducted by ＂Z＂ flaps plasty, and cervical parts of nipple were constructed with the state of nipple maintained,
RESULTS： A total of 33 enrolled patients were involved in the analysis of results, During the follow up of 1 year after operation, no recurrence of inversion or significant scars formation were observed, and the nipples showed a sywanetrical and satisfactory results,
CONCLUSION： Modified Sakai approach is a new method that can give consideration to beth function and appearance of nipple,
出处
《中国临床康复》
CSCD
北大核心
2006年第28期34-36,共3页
Chinese Journal of Clinical Rehabilitation
