Abstract: Objective　To investigate the clinical value of self-made bandage via postoperative use of it in patients with modified radical mastectomy.Methods　The enrolled participants were 60 patients undergoing modified radical mastectomy by the same group of surgeons in Thyroid and Breast Surgery，the Eighth Affiliated Hospital，Sun Yat-sen University between May 2010 and October 2016.Using block randomization method，they were allocated into group A and group B.For binding up the wound postoperatively，normal elastic bandage was used for group A，while self-made bandage was adopted for group B.The incidence of postoperative skin flap necrosis，incidence of subcutaneous effusion，rate of grade Ⅰ wound healing，the average extubation time，average daily drainage volume，average length of stay（LOS） and postoperative reported comfort were compared between the groups.Results　Compared with group A，group B demonstrated lower postoperative incidence of skin flap necrosis〔6.7%（2 cases） vs 26.7%（8 cases）〕（χ2=4.32，P=0.038），lower incidence of subcutaneous effusion〔6.7%（2 cases） vs 30.0%（9 cases）〕（χ2=5.46，P=0.020），but higher rate of grade Ⅰ wound healing〔93.3%（28 cases） vs 73.3%（22 cases）〕（χ2=4.32，P=0.038）． Moreover，group B showed shorter average extubation time（insertion sites of armpit and protothorax），and LOS，as well as less average daily drainage volume（P<0.001）． In addition，group B had lower rate of injection of analgesic drugs〔10.0% （3 cases） vs 33.3% （10 cases）〕（χ2=4.81，P=0.028），lower rate of respiratory limitations〔6.7%（2 cases） vs 26.7%（8 cases）〕（χ2=4.32，P=0.038），and lower rate of being confined passive position〔6.7%（2 cases） vs 30.0%（9 cases）〕（χ2=5.46，P=0.020） than group A.Conclusion　Using self-made bandage for binding up the wound postoperatively，can reduce the incidence of subcutaneous effusion，decrease the incidence of skin flap necrosis，increase the rate of grade Ⅰ wound healing，shorten the extubation time and LOS，decline the daily drainage volume and improve the postoperative comfort，so it is worthy of clinical promotion.

Key words: Breast neoplasms, Modified radical mastectomy, Self-made bandage

摘要： 目的　观察自制绷带在乳腺癌术后的临床应用效果，探讨其临床使用价值。方法　选取2010年5月—2016年10月中山大学附属第八医院甲乳外科同一组临床医生施行的乳腺癌改良根治术患者60例，采用随机数字表法将其分为普通弹力绷带包扎30例（A组）和自制绷带包扎30例（B组）。观察两组术后皮瓣坏死、皮下积液、甲级愈合、平均拔管时间、日引流量、平均住院时间和术后舒适度。结果　A组皮瓣坏死8例（26.7%），皮下积液9例（30.0%），甲级愈合22例（73.3%）；B组皮瓣坏死2例（6.7%），皮下积液2例（6.7%），甲级愈合28例（93.3%）。A组皮瓣坏死、皮下积液发生率均高于B组，甲级愈合率低于B组（χ2=4.32，P=0.038；χ2=5.46，P=0.020；χ2=4.32，P=0.038）。A组腋窝平均拔管时间、胸前平均拔管时间、平均住院时间均长于B组，日引流量多于B组（P<0.001）。A组注射止痛药物10例（33.3%），呼吸受限8例（26.7%），被动体位9例（30.0%）；B组注射止痛药物3例（10.0%），呼吸受限2例（6.7%），被动体位2例（6.7%）。A组注射止痛药物、呼吸受限、被动体位发生率均高于B组（χ2=4.81，P=0.028；χ2=4.32，P=0.038；χ2=5.46，P=0.020）。结论　乳腺癌患者术后应用自制绷带可减少皮下积液发生，降低皮瓣坏死率，提高切口甲级愈合，缩短拔管时间，减少日引流量，节约平均住院日，提高患者术后舒适度，值得临床推广。

关键词: 乳腺肿瘤, 乳腺癌改良根治术, 自制绷带