CAJ | 학술논문

目的探讨乳房内注入的聚丙烯酰胺水凝胶 (polyacrylamide hydrogel,PAHG)取出术后,乳房形态的修复方法. 方法对36例取出术后半年进行乳房形态的Ⅱ期修复,所有受术者术前均行MRI检查,以明确注射PAHG残留量及分布.根据组织缺损情况进行分类,综合采用自体脂肪颗粒注射、硅凝胶假体置入、脱细胞异体真皮或自体真皮游离移植等方法进行修复.结果本组所有受术者乳房形态均得到明显改善,无感染、乳房结节、假体边缘外露等并发症出现;手术效果的满意率为97.2%.结论 PAHG取出术后乳房形态的Ⅱ期修复手术应在取出术后半年进行,根据乳房局部组织缺损情况采用个性化的手术方案,针对不同层次的组织缺损综合采用自体脂肪颗粒注射移植、硅凝胶乳房假体置入、真皮片游离移植等方法,可最大限度地恢复和改善PAHG取出术后乳房畸形的外观.
목적 탐토유방내주입적취병희선알수응효 (polyacrylamide hydrogel,PAHG)취출술후,유방형태적수복방법. 방법 대36례취출술후반년진행유방형태적Ⅱ기수복,소유수술자술전균행MRI검사,이명학주사PAHG잔류량급분포.근거조직결손정황진행분류,종합채용자체지방과립주사、규응효가체치입、탈세포이체진피혹자체진피유리이식등방법진행수복.결과본조소유수술자유방형태균득도명현개선,무감염、유방결절、가체변연외로등병발증출현;수술효과적만의솔위97.2%.결론 PAHG취출술후유방형태적Ⅱ기수복수술응재취출술후반년진행,근거유방국부조직결손정황채용개성화적수술방안,침대불동층차적조직결손종합채용자체지방과립주사이식、규응효유방가체치입、진피편유리이식등방법,가최대한도지회복화개선PAHG취출술후유방기형적외관.
Objective To evaluate the methods of correction for secondary deformity after removal of polyacrylamide hydrogel in breast.Methods From June 2006 to December 2007,the Center of Breast Plastic and Reconstruction at Chinese Academy of Medical Sciences admitted and treated 36 patients who experienced deformity after polyacrylamide hydrogel remoral in breasts.The average age of the patients was 27.5 years,and the time of consultation for the correction was from 6 months postoperatively.The patients who had preoperative MRI examinations showed that no visible polyacrylamide hydrogel remained in the breast were included in the study.The patients were classified according to the deformity of the breast and the chest wall tissue.Autologous fat injection grafting,silicon gel implant augmentation,and dermis grafting were performed for treating the deformity of the breasts after polyacrylamide hydrogel removal.Results During 3 to 18 months follow-up,the shape of the breast was improved and no complications such as infection,the sclerotic nodules,implant exposure occurred.35(97.2%) patients were satisfied with the result of the operations.Conclusions The correction for secondary deformity of breast after removal of PAHG should be performed at least 6 months after removal of polyacrylamide hydrogel.The optimal and nature contour of the breast may be recovered by combination of various surgical methods which are carefully selected according to the individual situation.