According to foreign literature, the rate of subcutaneous fluid accumulation after radical breast cancer surgery is 35%, and some scholars call subcutaneous fluid accumulation “an inevitable disaster”. Subcutaneous effusion causes the separation of the flap from the chest wall, resulting in the failure to establish capillary anastomosis between the two, which affects the blood flow of the flap; the exudation of tissue fluid, lymphatic fluid and blood from the trauma surface and the formation of effusion from necrotic liquefied fatty tissue, which increases the number of days of hospitalization, medical expenses and mental stress of the patient.
Causes of fluid accumulation
1, poor drainage of the skin flap and blockage of the drainage tube.
2, the separation range is too large.
3, poor blood supply to the flap is the main cause of flap necrosis after breast cancer surgery.
4. lack of certain tension in the suture of the skin flap
5, hemostasis without measuring the bottom.
6, unstable or uneven bandaging resulting in dead cavity.
7, lymphatic leakage.
8, heat transfer from the electric knife, increasing the rate of liquefaction of subcutaneous fat.
9, underlying diseases: hypertension, diabetes, obesity.
10, premature upper limb activity, coughing.
11, premature drainage tube removal.
Measures to prevent effusion
1, appropriate ligation of large lymphatic vessels.
2.pressure bandaging in key areas.
3.Protein gel spraying.
4.Reducing traumatic exudation and repeatedly flushing the traumatic cavity.
5. suturing so that there is some tension in the skin pieces.
6.Continuous negative pressure drainage with frequent rounds.
7. the lateral holes of the intraoperatively placed drainage tubes should not be too small.
8, avoid premature and substantial activity of the upper limb.
9.Apply axillary flap with latissimus dorsi and anterior peroneal muscle to prevent subcutaneous fluid accumulation after breast cancer surgery.
Treatment of subcutaneous fluid accumulation
1.Repeated aspiration by syringe.
2.External syringe with indwelling intravenous cannula needle.
3.Re-cannulation with negative pressure suction.
4.open wound dressing change.
5, radiotherapy.
6.Pantothenic glucosamine gel flush.
In conclusion, unobstructed drainage, reasonable pressure dressing, continuous negative pressure suction and scientific extubation measures are the keys to prevent subcutaneous effusion.