title: Origin and countermeasure for common skin flap complications after radical operation for breast cancer.
abstract: OBJECTIVE
  To discuss the various factors which cause the common skin flap complications after radical operation for breast cancer.
  
  
  METHODS
  Two hundred sixteen patients with T1-3N0-1M0 breast cancer underwent radical surgery at The Cancer Hospital of Xingtai City, China during 1995-2003. Patey mastectomy was performed in majority of patients. Skin flaps were dissected using scalpel after injecting adrenaline containing saline into subcutaneous tissue. Diathermy was used only to stop bleeding vessels. A subset of patients who developed abnormal vascularity of skin flaps, seroma collection and flap necrosis was analyzed. Pressure garment and suction drains were used routinely. Flap necrosis < 3cm(2) was allowed to heal with secondary intention whereas larger defects were skin grafted.
  
  
  RESULTS
  In 56 patients, flap associated complications were noted. Abnormal vascularity, flap necrosis and seroma collection were absorbed in 34 (15.7%), 13 (6%) and 9 (4.2%) patients, respectively. Eight patients (3.7%) required skin grafting. All patients were discharged with full recovery.
  
  
  CONCLUSIONS
  To minimize the skin flap complications after radical surgery for breast cancer, lesser use of cautery, injection of adrenaline containing solution into subcutaneous tissue, routine use of suction drains and application of pressure garment may be recommended.
authors.affiliation: Xingtai County Hospital, Xingtai, Hebei, China.
authors.forename: W U
authors.initials: WU
authors.lastname: Hongying
authors.forename: Z C
authors.initials: ZC
authors.lastname: Shan
authors.forename: B
authors.initials: B
authors.lastname: Thakuri
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D015411:Mastectomy, Modified Radical; D008875:Middle Aged; D011183:Postoperative Complications; D013524:Surgical Flaps