背景:日间手术正在发展,其普及程度越来越高,原因有多种:经济限制,专业实践的变化,患者的附着力更大。在外科手术进步的时代,如果由经验丰富的团队计划和管理,带蒂穿支皮瓣可以减少供体部位的发病率并避免微吻合,可以在Day手术中占据一席之地。
方法:在2019年1月至2021年1月期间,我们在门诊环境中进行了穿支皮瓣覆盖软组织。回顾性纳入患者,并通过回顾病历收集数据。记录主要和次要并发症。
结果:回顾性队列包括32例患者的32例外科手术。在所有情况下,穿支皮瓣用于肿瘤皮肤科手术后修复软组织缺损(84.3%),软组织肉瘤手术(12.5%),浸润性导管乳腺癌(3.1%)。需要手术翻修的主要并发症克服了3/32倍(9.4%)。在这些情况下,一次需要从襟翼上放下的故障克服了一次。平均伤口愈合时间为33天(15-90),平均随访时间为9.6个月(1-22)。
结论:我们系列的低并发症率表明,在门诊手术中首次使用穿支皮瓣的经验在安全性和可行性方面是有希望的。日间手术可能是这种类型的外科手术的实用选择,避免了常规部门的饱和,并允许提供适当的手术护理。
BACKGROUND: Day surgery is developing and its popularity is increasing for a variety of reasons: economic constraints, changes in professional practices, a greater adhesion of the patient. In an era of progress in surgical procedures, pedicled-perforator flaps reducing donor site morbidity and avoiding micro-anastomosis could take their place in Day surgery if planned and managed by an experienced team.
METHODS: In the period January 2019 to January 2021, we performed perforator flaps for soft tissue coverage in ambulatory setting. The patients were included retrospectively and data were collected by reviewing the medical records. Major and minor complications were recorded.
RESULTS: The retrospective cohort included 32 surgical procedures in 32 patients. In all cases, perforator flaps were realized for resurfacing soft tissue defects consequent to oncodermatology surgery (84.3%), soft tissue sarcoma surgery (12.5%), invasive ductal breast carcinoma (3.1%). Major complications needing a surgical revision overcame 3/32 times (9.4%). In these cases, a failure requiring the drop off the flap overcame once. The average wound healing time was of 33 days (15-90) and the mean duration of follow-up was 9.6 months (1-22).
CONCLUSIONS: The low complication rate in our series suggests that this first experience on perforator flaps in outpatient surgery is promising in terms of safety and feasibility. Day surgery could be a practical option for this type of surgical procedures avoiding the conventional department\'s saturation and allowing the delivery of proper surgical cares.