Advances in Clinical and Experimental Medicine

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Advances in Clinical and Experimental Medicine

2009, vol. 18, nr 6, November-December, p. 657–667

Publication type: review article

Language: English

Postmastectomy Breast Reconstruction with Autologous Tissue – Free Flaps. Part II

Rekonstrukcje piersi po mastektomii tkankami własnymi – płaty wolne. Część II

Piotr Wójcicki1,, Piotr Wójcicki2,, Mariusz Wysocki2,

1 Department of Plastic Surgery, Wroclaw Medical University, Poland

2 Department of Plastic Surgery, Specialist Medical Center, Polanica Zdroj, Poland

Abstract

Breast cancer is the most common tumor occurring in women. Loss of a breast is a profound traumatic experience. Since the breast is a symbol of femininity, beauty, and motherhood, mastectomy can result in serious disorders of psychological and aesthetic character. Advances in microsurgical techniques facilitated the development of various methods indispensable for performing even the most extensive reconstructions with achievement of a good final result, opening the possibility for effective rehabilitation and a return to normal psychosocial functioning. Postmastectomy breast reconstruction with free flaps has become the standard course of action, and the choice of flaps assures selection of the best method available for each patient. This paper is a review of the most important free tissue flaps used in postmastectomy breast reconstruction, including the free transverse rectus abdominis myocutaneous (TRAM), the deep inferior epigastric perforator (DIEP), the paraumbilical perforator (PUP), the superior and inferior gluteal, the Rubens, and the thigh lateral transverse and anterolateral thigh flaps.

Streszczenie

Rak sutka jest najczęstszym nowotworem u kobiet. Utrata piersi jest tragicznym wydarzeniem wywołującym głęboki uraz psychiczny. Pierś jest symbolem kobiecości, urody oraz macierzyństwa, dlatego mastektomia prowadzi do zaburzeń natury psychicznej i estetycznej. Rozwój technik mikrochirurgicznych pozwolił na opracowanie różnych metod umożliwiających wykonanie nawet najbardziej rozległych rekonstrukcji z końcowym dobrym wynikiem, co daje szansę na skuteczną rehabilitację i powrót do normalnego funkcjonowania psychospołecznego. Obecnie rekonstrukcje piersi po mastektomii płatami wolnym stały się standardowym postępowaniem, a wybór między poszczególnymi płatami zapewnia dobór najlepszej metody dla każdej pacjentki. W artykule opisano najważniejsze wolne płaty tkankowe stosowane w mikrochirurgicznej rekonstrukcji piersi u kobiet po mastektomii. Omówiono wolny płat skórno−mięśniowy z mięśnia prostego brzucha, perforatorowy płat DIEP, płat oparty na perforatorze okołopępkowym, płaty pośladkowe górny i dolny, płat Rubensa, a także płat boczny poprzeczny uda i płat przednioboczny uda.

Key words

breast reconstruction, free flaps, breast cancer

Słowa kluczowe

rekonstrukcje piersi, płaty wolne, rak piersi

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