Nadir Mehmood, Naeem Zia, Idrees Anwar, Asif Zafar.
The Experience of Primary Closure Compared with Latissimus Dorsi Flap in Advanced Fungating Carcinoma of Breast after Mastectomy.
Ann Pak Inst Med Sci Jan ;10(1):43-9.

Objective: To assess the possibility and efficacy of primary closure compared with LD flap in advanced fungating carcinoma of breast. Study Design: Cross sectional comparative study. Place & Duration: Benazir Bhutto Hospital, Rawalpindi, from January 1999 to December 2012. Materials and Methods: This is an observational study comparing two types of wound closure in advanced fungating carcinoma of breast. The data was collected through admission registers of the ward and central registration office, as well as patients clinical record as maintained on history and examination sheets, investigations including histopathological and receptor studies, bone scan, digital photographs of breast lesions and follow up for recurrence and metastasis was done over a period of 14 years from January 1999 to December 2012. All the patients with breast cancer were registered in surgical unit I of Benazir Bhutto Hospital, Rawalpindi during the study period. All the patients who presented with recurrence/relapse, metastasis of already diagnosed carcinoma breast and carcinoma of opposite breast were excluded from the study. The demographic and other data of the breast cancer patients was recorded, tabulated and relevant statistical tests applied. Results: There were 1799 patients with malignant disease during the study period which is 5.62% of total admissions, 837 were male and 960 female. The number of patients with breast cancer was 682(2.13%) of total admissions in one surgical unit of the hospital. The two groups of patients were comparable in clinical disease staging, age, axillary node metastasis, frequency of histopathological and operative outcome as well as postoperative complications, local recurrence and survival. Primary closure of fungating LABC was possible and was far simple, resource restrictive and expedient way to help improve the quality of life of patients with fungating LABC compared LD flap closure of wound. Conclusion: Primary closure of the wound in advanced fungating carcinoma of breast is possible and the results are comparable to LD flap closure with reduced morbidity, operative time and less wound related complications.

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