Effects of dextran-40 on flap viability after modified radical mastectomy
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Auteurs : Baris Dogu Yildiz ; Barlas Sulu [Turquie]Source :
- The Canadian Journal of Plastic Surgery [ 1195-2199 ] ; 2013.
Abstract
Postoperative management of patients after modified radical mastectomy has evolved over the past decades. In the early postoperative period, wound complication rates were reported to be as high as 60%. Flap necrosis after modified radical mastectomy is a common problem encountered by surgeons. Various treatment strategies have been proposed in the literature but none have addressed the use of dextran-40.
To determine whether dextran-40 infusion improves skin flap viability after modified radical mastectomy.
Twenty-eight patients who underwent modified radical mastectomy were randomly assigned to receive dextran-40 or no dextran-40 intraoperatively after flap dissection. Patients were followed prospectively over a five-year period in a community hospital. The incidence of postmastectomy skin flap necrosis and prognosis of the necrotic area after dextran-40 infusion was observed.
Flap necrosis was observed in five (17.8%) patients. Hypertension and diabetes mellitus were found to be risk factors for the development of flap necrosis (P<0.05). Flap thickness and tension on the flaps were found to be related to flap necrosis. Six of seven patients with flap perfusion problems (ecchymosis or necrosis) underwent dextran-40 treatment and healed without graft replacement.
Dextran-40 treatment did not affect development of flap necrosis. However, if necrosis had already developed, the necrotic area of the skin flaps improved with dextran-40 treatment.
Url:
PubMed: 24431947
PubMed Central: 3891096
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Baris Dogu Yildiz<affiliation><nlm:aff id="af1-cjps21083">Department of Surgery, Ankara Numune Training Hospital, Ankara;</nlm:aff><wicri:noCountry code="subfield">Ankara</wicri:noCountry></affiliation>Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Effects of dextran-40 on flap viability after modified radical mastectomy</title><author><name sortKey="Yildiz, Baris Dogu" sort="Yildiz, Baris Dogu" uniqKey="Yildiz B" first="Baris Dogu" last="Yildiz">Baris Dogu Yildiz</name><affiliation><nlm:aff id="af1-cjps21083">Department of Surgery, Ankara Numune Training Hospital, Ankara;</nlm:aff><wicri:noCountry code="subfield">Ankara</wicri:noCountry></affiliation></author><author><name sortKey="Sulu, Barlas" sort="Sulu, Barlas" uniqKey="Sulu B" first="Barlas" last="Sulu">Barlas Sulu</name><affiliation wicri:level="1"><nlm:aff id="af2-cjps21083">Kafkas University Faculty of Medicine, General Surgery, Kars, Turkey</nlm:aff><country xml:lang="fr">Turquie</country><wicri:regionArea>Kafkas University Faculty of Medicine, General Surgery, Kars</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24431947</idno><idno type="pmc">3891096</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3891096</idno><idno type="RBID">PMC:3891096</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">002D23</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002D23</idno><idno type="wicri:Area/Pmc/Curation">002D22</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002D22</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Effects of dextran-40 on flap viability after modified radical mastectomy</title><author><name sortKey="Yildiz, Baris Dogu" sort="Yildiz, Baris Dogu" uniqKey="Yildiz B" first="Baris Dogu" last="Yildiz">Baris Dogu Yildiz</name><affiliation><nlm:aff id="af1-cjps21083">Department of Surgery, Ankara Numune Training Hospital, Ankara;</nlm:aff><wicri:noCountry code="subfield">Ankara</wicri:noCountry></affiliation></author><author><name sortKey="Sulu, Barlas" sort="Sulu, Barlas" uniqKey="Sulu B" first="Barlas" last="Sulu">Barlas Sulu</name><affiliation wicri:level="1"><nlm:aff id="af2-cjps21083">Kafkas University Faculty of Medicine, General Surgery, Kars, Turkey</nlm:aff><country xml:lang="fr">Turquie</country><wicri:regionArea>Kafkas University Faculty of Medicine, General Surgery, Kars</wicri:regionArea></affiliation></author></analytic><series><title level="j">The Canadian Journal of Plastic Surgery</title><idno type="ISSN">1195-2199</idno><idno type="eISSN">1918-1507</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>BACKGROUND:</title><p>Postoperative management of patients after modified radical mastectomy has evolved over the past decades. In the early postoperative period, wound complication rates were reported to be as high as 60%. Flap necrosis after modified radical mastectomy is a common problem encountered by surgeons. Various treatment strategies have been proposed in the literature but none have addressed the use of dextran-40.</p></sec><sec><title>OBJECTIVE:</title><p>To determine whether dextran-40 infusion improves skin flap viability after modified radical mastectomy.</p></sec><sec><title>METHODS:</title><p>Twenty-eight patients who underwent modified radical mastectomy were randomly assigned to receive dextran-40 or no dextran-40 intraoperatively after flap dissection. Patients were followed prospectively over a five-year period in a community hospital. The incidence of postmastectomy skin flap necrosis and prognosis of the necrotic area after dextran-40 infusion was observed.</p></sec><sec><title>RESULTS:</title><p>Flap necrosis was observed in five (17.8%) patients. Hypertension and diabetes mellitus were found to be risk factors for the development of flap necrosis (P<0.05). Flap thickness and tension on the flaps were found to be related to flap necrosis. Six of seven patients with flap perfusion problems (ecchymosis or necrosis) underwent dextran-40 treatment and healed without graft replacement.</p></sec><sec><title>CONCLUSIONS:</title><p>Dextran-40 treatment did not affect development of flap necrosis. However, if necrosis had already developed, the necrotic area of the skin flaps improved with dextran-40 treatment.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Can J Plast Surg</journal-id><journal-id journal-id-type="iso-abbrev">Can J Plast Surg</journal-id><journal-id journal-id-type="publisher-id">PGI</journal-id><journal-title-group><journal-title>The Canadian Journal of Plastic Surgery</journal-title></journal-title-group><issn pub-type="ppub">1195-2199</issn><issn pub-type="epub">1918-1507</issn><publisher><publisher-name>Pulsus Group Inc</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">24431947</article-id><article-id pub-id-type="pmc">3891096</article-id><article-id pub-id-type="publisher-id">cjps21083</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject></subj-group></article-categories><title-group><article-title>Effects of dextran-40 on flap viability after modified radical mastectomy</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Yildiz</surname><given-names>Baris Dogu</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="af1-cjps21083"><sup>1</sup></xref><xref ref-type="corresp" rid="c1-cjps21083"></xref></contrib><contrib contrib-type="author"><name><surname>Sulu</surname><given-names>Barlas</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="af2-cjps21083"><sup>2</sup></xref></contrib></contrib-group><aff id="af1-cjps21083"><label>1</label>Department of Surgery, Ankara Numune Training Hospital, Ankara;</aff><aff id="af2-cjps21083"><label>2</label>Kafkas University Faculty of Medicine, General Surgery, Kars, Turkey</aff><author-notes><corresp id="c1-cjps21083">Correspondence: Dr Baris Dogu Yildiz, Selanik cad 29/2 Kizilay 06650, Ankara, Turkey. Telephone 90-532-445-46-55, fax 90-312-424-15-20, e-mail <email>baris104@yahoo.com</email></corresp></author-notes><pub-date pub-type="ppub"><season>Summer</season><year>2013</year></pub-date><volume>21</volume><issue>2</issue><fpage>83</fpage><lpage>86</lpage><permissions><copyright-statement>©2013 Canadian Society of Plastic Surgeons. All rights reserved</copyright-statement><copyright-year>2013</copyright-year></permissions><abstract><sec><title>BACKGROUND:</title><p>Postoperative management of patients after modified radical mastectomy has evolved over the past decades. In the early postoperative period, wound complication rates were reported to be as high as 60%. Flap necrosis after modified radical mastectomy is a common problem encountered by surgeons. Various treatment strategies have been proposed in the literature but none have addressed the use of dextran-40.</p></sec><sec><title>OBJECTIVE:</title><p>To determine whether dextran-40 infusion improves skin flap viability after modified radical mastectomy.</p></sec><sec><title>METHODS:</title><p>Twenty-eight patients who underwent modified radical mastectomy were randomly assigned to receive dextran-40 or no dextran-40 intraoperatively after flap dissection. Patients were followed prospectively over a five-year period in a community hospital. The incidence of postmastectomy skin flap necrosis and prognosis of the necrotic area after dextran-40 infusion was observed.</p></sec><sec><title>RESULTS:</title><p>Flap necrosis was observed in five (17.8%) patients. Hypertension and diabetes mellitus were found to be risk factors for the development of flap necrosis (P<0.05). Flap thickness and tension on the flaps were found to be related to flap necrosis. Six of seven patients with flap perfusion problems (ecchymosis or necrosis) underwent dextran-40 treatment and healed without graft replacement.</p></sec><sec><title>CONCLUSIONS:</title><p>Dextran-40 treatment did not affect development of flap necrosis. However, if necrosis had already developed, the necrotic area of the skin flaps improved with dextran-40 treatment.</p></sec></abstract><trans-abstract xml:lang="fr"><sec><title>HISTORIQUE:</title><p>La prise en charge postopératoire des patientes qui ont subi une mastectomie radicale modifiée a évolué depuis quelques décennies. Au début de la période postopératoire, le taux de complication des plaies peut atteindre les 60 %. La nécrose des lambeaux après une mastectomie radicale modifiée est un problème courant pour les chirurgiens. Diverses stratégies thérapeutiques sont proposées dans les publications, mais aucune n’a porté sur l’utilisation de dextran 40.</p></sec><sec><title>OBJECTIF:</title><p>Déterminer si l’injection de dextran 40 améliore la viabilité des lambeaux cutanés après une mastectomie radicale modifiée.</p></sec><sec><title>MÉTHODOLOGIE:</title><p>Vingt-huit patientes ayant subi une mastectomie radicale modifiée ont été réparties au hasard pour recevoir ou non du dextran 40 pendant l’opération, après la dissection des lambeaux. Elles ont subi un suivi prospectif de cinq ans dans un hôpital général. Les chercheurs ont évalué l’incidence de nécrose des lambeaux cutanés après une mastectomie et le pronostic de zone nécrosée après l’injection de dextran 40.</p></sec><sec><title>RÉSULTATS:</title><p>Les chercheurs ont observé une nécrose des lambeaux chez cinq patientes (17,8 %). L’hypertension et le diabète étaient des facteurs de risque (P<0,05). L’épaisseur et la tension des lambeaux y étaient liées. Six des sept patientes présentant des problèmes de perfusion des lambeaux (ecchymose ou nécrose) ont subi un traitement au dextran 40 et ont guéri sans qu’il soit nécessaire de remplacer la greffe.</p></sec><sec><title>CONCLUSIONS:</title><p>Le traitement au dextran 40 n’influait pas sur l’apparition d’une nécrose des lambeaux, mais en présence d’une nécrose, l’état de la zone nécrosée des lambeaux cutanés s’améliorait grâce au traitement au dextran 40.</p></sec></trans-abstract><kwd-group><kwd>Breast cancer</kwd><kwd>Breast surgery</kwd><kwd>Flap circulation</kwd><kwd>Flap surgery</kwd><kwd>Mastectomy</kwd><kwd>Resection</kwd><kwd>Skin flap</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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