PDF(Pubmed)
Abstract：
UNASSIGNED: Breast reconstruction following mastectomy is a critical component of breast cancer treatment, aimed at improving patient quality of life. However, the management is fraught with potential complications, including skin necrosis and wound dehiscence, which can significantly impact clinical outcomes.
UNASSIGNED: We report a unique case of a patient, 5 years post-breast reconstruction following mastectomy and radiation therapy, who developed severe skin necrosis and wound dehiscence due to a brown recluse spider bite on the reconstructed breast. The complication necessitated the debridement of skin, removal of the implant, and further reconstruction with a latissimus flap.
UNASSIGNED: The case underscores the unusual etiology of spider bite-induced necrosis in breast reconstruction and highlights the challenges and strategic considerations in managing such complications. Upon presentation, the patient\'s affected breast area showed signs of extensive necrosis and wound dehiscence, directly attributed to the cytotoxic effects of the brown recluse spider\'s venom. The venom\'s pathophysiology involves a complex cascade, leading to local and systemic effects. The local effects, marked by dermonecrosis, com- promised skin integrity in this instance. Systemic effects, not observed in this patient but potentially severe, can include hemolysis, coagulopathy, and acute renal failure, highlighting the seriousness of brown recluse spider bites.
UNASSIGNED: In conclusion, this case illustrates the complexities of managing breast reconstruction post-mastectomy complications, particularly those caused by external factors such as brown recluse spider bites. It highlights the need for meticulous attention to unusual etiologies of necrosis and dehiscence, demonstrating the importance of adaptable surgical strategies and a thorough understanding of venom pathophysiology in ensuring successful patient outcomes.
UNASSIGNED: We report a unique case of a patient, 5 years post-breast reconstruction following mastectomy and radiation therapy, who developed severe skin necrosis and wound dehiscence due to a brown recluse spider bite on the reconstructed breast. The complication necessitated the debridement of skin, removal of the implant, and further reconstruction with a latissimus flap.
UNASSIGNED: The case underscores the unusual etiology of spider bite-induced necrosis in breast reconstruction and highlights the challenges and strategic considerations in managing such complications. Upon presentation, the patient\'s affected breast area showed signs of extensive necrosis and wound dehiscence, directly attributed to the cytotoxic effects of the brown recluse spider\'s venom. The venom\'s pathophysiology involves a complex cascade, leading to local and systemic effects. The local effects, marked by dermonecrosis, com- promised skin integrity in this instance. Systemic effects, not observed in this patient but potentially severe, can include hemolysis, coagulopathy, and acute renal failure, highlighting the seriousness of brown recluse spider bites.
UNASSIGNED: In conclusion, this case illustrates the complexities of managing breast reconstruction post-mastectomy complications, particularly those caused by external factors such as brown recluse spider bites. It highlights the need for meticulous attention to unusual etiologies of necrosis and dehiscence, demonstrating the importance of adaptable surgical strategies and a thorough understanding of venom pathophysiology in ensuring successful patient outcomes.
摘要：
■乳房切除术后的乳房重建是乳腺癌治疗的关键组成部分，旨在改善患者的生活质量。然而,管理层充满了潜在的并发症，包括皮肤坏死和伤口裂开,这可以显着影响临床结果。
■我们报告了一个患者的独特病例，乳房切除术和放射治疗后的乳房重建5年，由于棕色隐居蜘蛛咬伤了重建的乳房，导致严重的皮肤坏死和伤口开裂。并发症需要皮肤清创，移除植入物，用背阔肌皮瓣进一步重建。
该案例强调了乳房重建中蜘蛛咬伤引起的坏死的异常病因，并强调了处理此类并发症的挑战和战略考虑。在介绍时，患者受累的乳房区域表现出广泛坏死和伤口裂开的迹象，直接归因于棕色隐士蜘蛛毒液的细胞毒性作用。毒液的病理生理学涉及复杂的级联，导致局部和系统性影响。局部影响,以皮肤坏死为标志，在这种情况下，妥协的皮肤完整性。系统效应,在该患者中未观察到，但可能严重，可能包括溶血，凝血病,急性肾衰竭,突出棕色隐士蜘蛛叮咬的严重性。
■总而言之，这个案例说明了乳房再造的复杂性，乳房切除术后并发症，特别是那些由外界因素引起的，如棕色隐士蜘蛛叮咬。它强调了对不寻常的坏死和开裂病因的细致关注，证明了适应性手术策略的重要性以及对毒液病理生理学的透彻了解在确保患者成功结局方面的重要性。
■我们报告了一个患者的独特病例，乳房切除术和放射治疗后的乳房重建5年，由于棕色隐居蜘蛛咬伤了重建的乳房，导致严重的皮肤坏死和伤口开裂。并发症需要皮肤清创，移除植入物，用背阔肌皮瓣进一步重建。
该案例强调了乳房重建中蜘蛛咬伤引起的坏死的异常病因，并强调了处理此类并发症的挑战和战略考虑。在介绍时，患者受累的乳房区域表现出广泛坏死和伤口裂开的迹象，直接归因于棕色隐士蜘蛛毒液的细胞毒性作用。毒液的病理生理学涉及复杂的级联，导致局部和系统性影响。局部影响,以皮肤坏死为标志，在这种情况下，妥协的皮肤完整性。系统效应,在该患者中未观察到，但可能严重，可能包括溶血，凝血病,急性肾衰竭,突出棕色隐士蜘蛛叮咬的严重性。
■总而言之，这个案例说明了乳房再造的复杂性，乳房切除术后并发症，特别是那些由外界因素引起的，如棕色隐士蜘蛛叮咬。它强调了对不寻常的坏死和开裂病因的细致关注，证明了适应性手术策略的重要性以及对毒液病理生理学的透彻了解在确保患者成功结局方面的重要性。
