BÁO CÁO CA LÂM SÀNG: VẠT MẠCH XUYÊN CÁNH TAY SAU TÁI TẠO TỔN KHUYẾT NÁCH DO LOÉT XẠ TRỊ NHIỄM TRÙNG

Abstract

Axillary defect is one of the rare injury in Vietnam. The article reports the clinical case: an 81-year-old female patient with an infected ulcer in the axillary, who had history of right breast cancer 30 years ago and underwent radical surgery, axillary lymphadenectomy, extensive radiation therapy to the right axillary and chest. Computed tomography scan of the chest assessed the deep of injury and biopsy ruled out cancer. The treatment plan was given: treatment of infections according to the antibiogram, local injury care, debridement, using negative pressure wound therapy; when the injury was clean and the granulation tissue was good, reconstructive surgery had been carried out. According to the reconstruction ladder, many reconstructive techniques were offered, the optimal choice in this case was to use the posterior arm perforator flap. After surgery, the posterior arm flap had good vitality, the incisions was healed after 3 weeks. The donor site had soft edema of the arm, forearm and hand, because of using the large flap, the arm incision caused limited venous return, but after 3 weeks, the edema and swelling was completely gone. Report’s conclusion  confirms that the posterior arm perforator flap are well suited for axillary coverage and should be considered among the main options for axillary reconstruction