FIELD: medicine; reconstructive surgery.
SUBSTANCE: skin is incised along the edge of the areola with the transition to the outer quadrants of the mammary gland to the axillary region. In this case, the breast tissue is removed either subcutaneously or using skin-saving technology with the removal of a nipple-areolar complex. Then the formation of the pocket, and mobilization of the pectoralis major muscle from the chest wall are performed. Perforating vessels are carefully coagulated, additional isolation and mobilization of the pectoralis minor muscle are carried out. The inferolateral places of attachment of the pectoralis minor muscle to the chest are electrosurgically crossed, leaving the chest at the upper point of fixation and nutrition, after installing the endoprosthesis of its fixation on top of it, the pectoralis minor muscle is fixed with a continuous suture: medially — to the pectoralis major muscle; laterally — to the dentate muscle; downwards — to the area of intersection of the lower bundle of the pectoralis major muscle and the serratus muscle. Layer-by-layer suturing of the wound and the imposition of an aseptic bandage are performed.
EFFECT: method allows to minimize trauma, completely or to a greater extent cover the endoprosthesis with the patient’s tissues and increase the rate of patient recovery in the postoperative period, removing drainage on days 3–4 and reducing the time before the start of subsequent combined treatment, the method is also absolutely safe for oncological patients and does not affect course of cancer.
1 cl, 5 ex, 1 tbl, 5 dwg
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Authors
Dates
2023-07-18—Published
2022-07-26—Filed