Original Article
Perioperative nursing for immediate breast reconstruction with deep inferior epigastric perforator flap after breast cancer resection
Abstract
Background: To investigate the value of the nursing cooperation workflow for immediate breast reconstruction with deep inferior epigastric perforator (DIEP) flap after breast cancer resection.
Methods: The clinical data of 29 patients who had undergone immediate breast reconstruction with DIEP flap after breast cancer resection in our center from January 2016 to December 2017 were retrospectively analyzed. In particular, the nursing cooperation workflow was reviewed.
Results: All the 29 patients were emotionally stable before surgery and were able to cooperate well with the surgery. The surgery was smooth. In 27 patients, the flaps survived after surgery and primary healing was achieved at the wounds. The remaining two cases presented with venous vascular crisis within 24 h after the surgery, and the flaps survived after active rescue. The patients were followed up for 4 months to 3 years. Neither complication such as local tumor recurrence, incision infection, flap necrosis, or upper limb lymphedema in the surgical area nor complication such as abdominal wall bulging, abdominal wall hernia, or fat liquefaction of incision in the donor area was reported. The shape of the reconstructed breasts was natural and satisfactory.
Conclusions: Immediate breast reconstruction with DIEP flap after breast cancer resection involves two disciplines: tumor resection and plastic repair. It is time-consuming and difficult to perform. Before the surgery, nurses in the operating room should carefully assess the patient's disease condition, communicate well with the operator, fully understand and be familiar with the surgical procedure and its special requirements, and formulate the surgical cooperation plan. During the surgery, the nurses should strictly implement cancer-free technique and be ready to assist for every next step, so as to effectively shorten the operative time, prevent local tumor recurrence, and thus pave the way for a successful surgery.
Methods: The clinical data of 29 patients who had undergone immediate breast reconstruction with DIEP flap after breast cancer resection in our center from January 2016 to December 2017 were retrospectively analyzed. In particular, the nursing cooperation workflow was reviewed.
Results: All the 29 patients were emotionally stable before surgery and were able to cooperate well with the surgery. The surgery was smooth. In 27 patients, the flaps survived after surgery and primary healing was achieved at the wounds. The remaining two cases presented with venous vascular crisis within 24 h after the surgery, and the flaps survived after active rescue. The patients were followed up for 4 months to 3 years. Neither complication such as local tumor recurrence, incision infection, flap necrosis, or upper limb lymphedema in the surgical area nor complication such as abdominal wall bulging, abdominal wall hernia, or fat liquefaction of incision in the donor area was reported. The shape of the reconstructed breasts was natural and satisfactory.
Conclusions: Immediate breast reconstruction with DIEP flap after breast cancer resection involves two disciplines: tumor resection and plastic repair. It is time-consuming and difficult to perform. Before the surgery, nurses in the operating room should carefully assess the patient's disease condition, communicate well with the operator, fully understand and be familiar with the surgical procedure and its special requirements, and formulate the surgical cooperation plan. During the surgery, the nurses should strictly implement cancer-free technique and be ready to assist for every next step, so as to effectively shorten the operative time, prevent local tumor recurrence, and thus pave the way for a successful surgery.
