Özet:

Purpose: In the autologist breast reconstruction, pain occurs in the receiver area due to the intervention of the bone marrow in the postoperative period. In this study, when preparing the receiver field in breast reconstruction, we aimed to reveal the effect of the costeric surgical approach on postoperative pain by comparing with the costeric non-protective approach. Patients and Method: 25 patients operated between 2018-2022 were included in the study. The groups were divided according to internal mammarian artery (IMA) isolation techniques. Group 1: Patients who are subject to bone protection surgery(n=9), Group 2: Patients who are subject to bone resection(n=16). During the postoperative period, both groups recorded the duration of the patient-controlled analgesic pump (HKA), the dose of morphine used, early and late pain scores. The average age of patients was 49.8 years. No complications occurred in the early and late postoperative period. All flip transfers were successful. The average HKA time was 24±1.41 hours in group 1 and 26.31±1.62 hours in group 2. The dose of morphine in Group 1 was 9.67 ± 1 mg, and in Group 2 23.93 ± 3.02 mg. Early pain score was 2.89±1.16 in group 1 and 5.18±1.22 in group 2. The late pain scores were 2.11±0.98 in group 1 and 2.75±0.77 in group 2. There was a statistically significant difference between the dosage of morphine and early pain scores of the groups (p<0,01). There was no significant difference between the time of use of HKA (p=0.3) and the late pain scores (p=0.07) (p>0.05). Result: As a result, the autologist believes that in the early period of preparation of the receiver area in breast reconstruction the pain is significantly reduced.