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    Mastectomy: Prepared By: Hilario, Eunice Lamoste, Jenebelle Lopez, Maria Sofia

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    Sofia Lopez
    A mastectomy is surgery to remove all breast tissue as a way to treat or prevent breast cancer. There are several types of mastectomy, including total, modified radical, partial, and nipple-sparing mastectomies. The mastectomy procedure involves making an elliptical skin incision, dissecting the breast tissue from the chest wall, and closing the incision with stitches. Preparation for mastectomy includes cleaning the skin with antiseptic cloths before surgery and positioning the patient supine with their arm stretched out on the operating table. Required equipment includes skin hooks, retractors, forceps, and scissors.

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    Mastectomy: Prepared By: Hilario, Eunice Lamoste, Jenebelle Lopez, Maria Sofia

    Uploaded by

    Sofia Lopez
    107 views34 pages
    A mastectomy is surgery to remove all breast tissue as a way to treat or prevent breast cancer. There are several types of mastectomy, including total, modified radical, partial, and nipple-sparing mastectomies. The mastectomy procedure involves making an elliptical skin incision, dissecting the breast tissue from the chest wall, and closing the incision with stitches. Preparation for mastectomy includes cleaning the skin with antiseptic cloths before surgery and positioning the patient supine with their arm stretched out on the operating table. Required equipment includes skin hooks, retractors, forceps, and scissors.

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    Mastectomy

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    A mastectomy is surgery to remove all breast tissue as a way to treat or prevent breast cancer. There are several types of mastectomy, including total, modified radical, partial, and nipple-sparing mastectomies. The mastectomy procedure involves making an elliptical skin incision, dissecting the breast tissue from the chest wall, and closing the incision with stitches. Preparation for mastectomy includes cleaning the skin with antiseptic cloths before surgery and positioning the patient supine with their arm stretched out on the operating table. Required equipment includes skin hooks, retractors, forceps, and scissors.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    107 views34 pages

    Mastectomy: Prepared By: Hilario, Eunice Lamoste, Jenebelle Lopez, Maria Sofia

    Uploaded by

    Sofia Lopez
    A mastectomy is surgery to remove all breast tissue as a way to treat or prevent breast cancer. There are several types of mastectomy, including total, modified radical, partial, and nipple-sparing mastectomies. The mastectomy procedure involves making an elliptical skin incision, dissecting the breast tissue from the chest wall, and closing the incision with stitches. Preparation for mastectomy includes cleaning the skin with antiseptic cloths before surgery and positioning the patient supine with their arm stretched out on the operating table. Required equipment includes skin hooks, retractors, forceps, and scissors.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 34
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    The key takeaways are that a mastectomy is surgery to remove breast tissue to treat or prevent breast cancer, and there are different types of mastectomy procedures like total, partial and nipple-sparing mastectomies.

    The different types of mastectomy procedures discussed are total (simple) mastectomy, modified radical mastectomy, partial mastectomy, and nipple-sparing mastectomy.

    Some risks of mastectomy include bleeding, infection, pain, swelling, formation of hard scar tissue, shoulder pain and stiffness, numbness and buildup of blood in the surgical site.

    MASTECTOMY

    Prepared by:
    Hilario, Eunice
    Lamoste, Jenebelle
    Lopez, Maria Sofia
    DEFINITION
    1 and
    DISCUSSION
    Definition
    A mastectomy is surgery to remove all breast tissue
    from a breast as a way to treat or prevent breast cancer.
    For those with early-stage breast cancer, a mastectomy
    may be one treatment option.
    Discussion
    Types of mastectomy
    Total (simple) mastectomy - The surgeon removes the entire breast and the lining of
    the chest muscle, but no other tissue.
    Modified radical mastectomy - The surgeon removes the entire breast, the lining of
    the chest muscles and the lymph nodes in the underarm area.

    Partial mastectomy - Partial mastectomy is the removal of the cancerous part of the
    breast tissue and some normal tissue around it
    Nipple-sparing mastectomy - During nipple-sparing mastectomy, all of the breast
    tissue is removed, but the nipple is left alone.
    Risks of a mastectomy include:

    ● Bleeding
    ● Infection
    ● Pain
    ● Swelling (lymphedema) in your arm if you have an axillary node dissection
    ● Formation of hard scar tissue at the surgical site
    ● Shoulder pain and stiffness
    ● Numbness, particularly under your arm, from lymph node removal
    ● Buildup of blood in the surgical site (hematoma)
    PROCEDUR
    2
    E
    PROCEDURE

    1. A #20 blade is used to make an elliptical skin incision that includes the nipple-
    areolacomplex (see the image below). The skin ellipse should be tailored so as to
    ensure the following:
    a. The resulting defect can be closed without tension
    b. Any old biopsy sites or surgical scars are included in the ellipse if possible
    c. The lateral end of the ellipse is medial to the midaxillary line
    PROCEDURE

    2. The incision is then deepened by means of a coagulation diathermy device.


    Subdermal veins will be encountered that must be coagulated.
    3. Littlewoods or skin hooks are applied to the superior flap, and the assistant lifts
    the superior flap. Flaps should always be lifted straight up, perpendicular to the
    chest wall. Sufficient tension should be maintained during lifting to ensure that the
    flap is the same thickness throughout and to prevent buttonholing.
    PROCEDURE

    4. With the diathermy device held parallel to the flap, the breast tissue
    is dissected away from one end of the incision to the other. There is
    no specific anatomic landmark that defines the depth of the
    dissection. However, if the flaps are approximately 5-10 mm thick, a
    bloodless plane becomes evident, representing the transition zone
    between subcutaneous tissue and breast tissue. If the wrong plane is
    used, bleeding will be heavy while the flap is raised.
    PROCEDURE
    5. The dissection is deepened to the pectoralis major, with care taken to
    coagulate vessels as they are encountered so as to minimize blood loss
    during the operation.It is important always to identify the limits of the
    dissection before starting to dissect the breast off the chest wall. The
    medial limit is the lateral border of the sternum, the lateral limit is the
    anterior border of the latissimus dorsi, the superior limit is the second rib,
    and the inferior limit is the inframammary crease.
    PROCEDURE

    6. This process is repeated for the lower flap, proceeding from the
    medial end to the lateral end.Toward the lateral end of the
    dissection, a Littlewoods forceps is placed on the superior flap and
    another on the inferior flap, close to the lateral angle of the
    incision. The dissection is deepened until the anterior border of the
    latissimus dorsi (the lateral limit of the dissection) is identified.
    PROCEDURE
    7. With the skin envelope raised completely, the next step is to lift the
    breast off the pectoralis major. Langenbeck retractors may be used to
    retract the flaps, starting at the medial angle. A perforating branch of the
    internal mammary artery is commonly encountered here; it should be
    coagulated with the diathermy device before it retracts. The breast is then
    lifted off the muscle, with care taken to ensure that all the perforators
    along the way are coagulated. At the lateral end of the dissection, the
    superior limit of the breast tissue as it approaches theaxilla is the first
    intercostal nerve.
    PROCEDURE

    8. As the surgery is completed, the incision is closed with stitches


    (sutures), which either dissolve or are removed later. You might
    also have one or two small plastic tubes placed where your breast
    was removed. The tubes will drain any fluids that accumulate after
    surgery. The tubes are sewn into place, and the ends are attached
    to a small drainage bag.
    PREPARATIO
    3
    N OF PATIENT
    Preparation
    General anesthesia is preferred for a simple mastectomy. The patient is placed supine with the ipsilateral arm
    stretched out level with the shoulder. The head end of the operating table is raised to 30º. The side being operated on
    is raised by 30º. The patient is draped with the armfree to allow for movements during the procedure. It is important
    not to hyperextend the arm
    When positioning the patient; hyperextension may cause significant postoperativeneurapraxia.

    Preparing for your surgery


    Tell your doctor about any medications, vitamins or supplements you're taking.
    Stop taking aspirin or other blood-thinning medication
    Don't eat or drink 8 to 12 hours before surgery
    Prepare for a hospital stay.
    SKIN
    4 PREPARATIO
    N
    Before surgery, you can play an important role in your own
    health. Because skin is not sterile, we need to be sure that your
    skin is as free of germs as possible before surgery. Along with
    your physician, CPMC has chosen disposable cloths moistened
    with rinse-free, alcohol-free, 2% Chlorhexidine Gluconate
    (CHG) antiseptic solution to reduce the risk of a post-surgical
    infection.
    Prepare your skin the night before and morning of your surgery

    1. Shampoo your hair and shower with warm (not hot) water at least one hour before using the CHG cloths.
    This allows your pores to close before using this product.

    a. Do not use a loofah or washcloth that has been sitting in the shower. These may harbor water loving
    bacteria.
    b. IMPORTANT: Do not shave under your arms for at least 5 days before surgery.

    2. After you shower, dry off completely with a clean towel. a. Do NOT apply any lotions, perfumes, or
    deodorant to your body. This is very important!

    3. Test a small area on your wrist for CHG allergy by wiping a CHG cloth on it. Let air dry for 5 minutes. If you
    have any redness, rash, or itching - do not use the CHG cloths.

    4. If your test area shows no reaction, follow the instructions below for use of the CHG cloths. Wipe each area
    very gently but thoroughly. Do not use the cloths on your face or genitals. Do not apply to broken skin or open
    wounds.
    1st cloth: wipe your entire neck, chest,
    and abdomen covering every area.

    2nd cloth: wipe your axilla (underarm) and the entire


    length of your arms in a downward motion.

    5. Let skin air dry after using the cloths (1 minute or so).
    It is normal for your skin to feel a little sticky for a few minutes until the solution dries
    completely.

    6. Throw all cloths out in the garbage. Do not flush them down the toilet. Do not apply any
    lotions, perfumes, or deodorant to your body. This will inactivate the CHG. Do not shower
    again after preparing the skin.

    7. Wear clean pajamas and sleep on clean sheets after bathing with CHG the night before
    your surgery.

    8. In the morning do not shower, but repeat the wiping routine with the second package of
    CHG cloths.
    EQUIPMENTS
    AND
    4
    SUPPLIES
    NEEDED
    Equipments and supply that will be needed:

    Sterile gloves and gown

    sterile drapes

    Preoperative skin preparation supplies

    Sterile sponges

    Sterile irrigation solution


    Equipments and supply that will be needed:

    Littlewoods, Lahey, or skin hooks for lifting the flaps

    Langenbeck retractors (medium-sized and large)

    Small artery forceps

    Nontoothed and toothed forceps

    Metzenbaum scissors

    Vacuum drain
    Equipments and supply that will be needed:

    Scalpel

    Drains for axilla and chest wall

    Several types of sutures and ties

    Silks available for ties

    Nylon for drain sutures

    Vicryl, and Monocryl for skin closure


    INSTRUMENT
    4
    ATION

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    INSTRUMENTATION

    A basic surgical set is required for a simple mastectomy. The key instruments are as
    follows:

    ● Littlewoods, Lahey, or skin hooks for lifting the flaps


    ● Langenbeck retractors (medium-sized and large)
    ● Small artery forceps
    ● Nontoothed and toothed forceps
    ● Metzenbaum scissors
    ● Scalpel (Blade Holder #4, #20 blade)
    Littlewoods, Lahey, or skin
    hooks

    used for lifting the flaps


    Langenbeck retractors
    (medium-sized and large)

    used to separate the edges of


    an incision
    Small artery forceps

    used for controlling bleeding


    and for the retraction of
    tissues, skin, etc.
    Nontoothed and toothed
    forceps

    Nontoothed forceps are used


    to hold tissue in place when
    applying sutures while
    toothed forceps handling
    dense tissue, such as in skin
    closures
    Metzenbaum scissors

    used for cutting delicate


    tissue and blunt dissection.
    Scalpel ((Blade Holder #4,
    #20 blade)

    used to make an elliptical


    skin incision that includes
    the nipple-areolacomplex
    REFERENCES

    https://www.academia.edu/5628952/mammary_tumour
    https://www.mayoclinic.org/tests-procedures/mastectomy/about/pac-20394670
    THANK YOU!

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