Method for breast reconstruction with rectus abdominis musculocutaneous unipedicled flap after mastectomy

摘要

The invention relates to medicine, in particular to oncology, and may be used for breast reconstruction with rectus abdominis musculocutaneous unipedicled flap after mastectomy in women with breast cancer.According to the invention, the claimed method consists in that it is performed the preoperative marking of the zone at the level of the removed breast, is marked the reexcision zone, then is performed the abdominal marking of the flap intake place, afterwards the lines are connected to form an ellipse, it is also marked the place of formation of a tunnel, through which will be performed the flap transposition. During the operation is performed the incision of the superior marked edge to the rectus abdominis aponeurosis, is detached this flap to the level of the last contralateral edges, afterwards is performed the said tunnel, are performed the incisions in accordance with the marking, is detached the flap from the paramedial sides up to 1 cm from the abdominal white line, then from the homolateral sides up to 1…2 cm laterally from the edge of the rectus abdominis muscle. Then it is incised 2 cm laterally from the white line the anterior leaf of the rectus abdominis aponeurosis with preservation of 4…5 cm of anterior leaf of the aponeurosis and is released the inferior vascular pedicle of the muscle, is mobilized the muscle in the upper side to the level of the xiphoid process. At the level of the lateral edges are ligated the perforants and intercostal nerves, then the flap is tunneled and placed in a recipient place, and on the anterior wall of the abdomen is additionally applied a preliminary prepared skin allograft. It is sutured the flap at the level of the defect, and on the skin in the region of the reconstituted breast is applied a hypoallergenic plaster of nonwoven fabric with polyacrylate-based adhesive.