FIELD: medicine, namely surgery, oncology and reconstructive plastic surgery.
SUBSTANCE: skin around the mammary gland is dissected with bordering incisions extended to the posterior axillary line, and the zone is de-epidermized within the anterior and posterior axillary region along the preoperative marking lines. Then a skin-sparing mastectomy is performed and a silicone implant is installed in the projection of the removed mammary gland. The de-epidermized zone is cut out and transferred to the area of the lateral edge of the implant, the skin cover over the implant is sutured, after dissection with bordering incisions and deep-epidermization of the skin along the preoperative marking lines from the anterior to posterior axillary region, the tissues of the de-epidermized zone are cut off along the medial, lateral and upper edges. Next, a de-epidermalized skin-fat flap is formed by dissection in the fatty layer, preserving the subdermal vascular blood supply. The formed flap is moved up along the edge of the lateral border of the installed implant, with the length of the flap corresponding to the length of the lateral edge of the installed implant, and the width of the flap corresponding to its length for adequate blood supply. Next, the skin-fat flap is fixed with absorbable sutures to the subcutaneous fat layer of the upper edge of the bordering incision, then the skin sheath is sutured along the entire length of the incision over the installed implant and over the de-epidermalized skin-fat flap.
EFFECT: method ensures a stable position of the anatomically shaped implant in the postoperative period.
1 cl, 2 ex, 10 dwg
