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目的：为了在乳癌根治术中达到既根治又美容的目的，我们对21例乳癌根治手术进行了改良。方法：改纵行切口为斜行的Orr切口；游离皮瓣时，采用自制的二齿皮肤牵拉钳拉平皮肤，以双刃刀作拉锯式切割均匀游离皮瓣；游离带蒂背阔肌肌瓣，将肌瓣翻转，填充于腋窝，末端与胸大肌锁骨端缝合固定，并覆盖于腋静脉、臂丛神经表面；创面内喷洒ZT胶或生物蛋白胶，减少渗血和术后渗出。结果：21例患者中术后发生皮瓣坏死的1例，无1例发生腋窝积液，1例发生切口旁皮下少量积液，平均住院12d。结论：彻底根治，预防术后局部复发，又减少了腋窝积液，皮瓣坏死等并发症，缩短了住院时间，又保持了外形的美观。
OBJECTIVE: To achieve the goal of both radical and cosmetic treatment in radical mastectomy, we have modified 21 cases of radical mastectomy. Methods: The Orr incision was changed to the oblique incision. When the free flap was used, the skin was made by using a self-made two-tooth skin pulling forceps. The double-edged knife was used for saw-cutting uniform free skin flaps; Flap, flip the muscle flap, fill in the armpit, end sutured with the clavicle end of the pectoralis major muscle, and cover the surface of the axillary vein and brachial plexus; spray ZT glue or bioprotein glue on the wound surface to reduce bleeding and postoperative bleeding . Results: One case of flap necrosis occurred in 21 patients. No one case had effusion, and 1 case had a small amount of effusion beside the incision. The average hospital stay was 12 days. Conclusions: Complete cure can prevent postoperative local recurrence, reduce complications such as effusion, flap necrosis, etc., shorten hospital stay, and maintain the appearance of appearance.