Nigerian Journal of Plastic Surgery

LETTER TO EDITOR
Year
: 2020  |  Volume : 16  |  Issue : 2  |  Page : 92--93

A Technical Innovation of Syringe Nipple Splint for Reconstructed Nipple


Shabeer Ahmad Wani, Luay Abdullah Al Salmi, Ovais Habib Matto, Hackle Joy Cabrias Caguimbay 
 Plastic Surgery Section, Department of Surgical Specialties, King Fahad Medical City Riyadh, Kingdom of saudi Arabia

Correspondence Address:
Dr. Shabeer Ahmad Wani
Associate Consultant Plastic Surgery Section, Department of Surgical Specialties, King Fahad Medical City Riyadh, Pin Code: 11525
Kingdom of saudi Arabia




How to cite this article:
Wani SA, Al Salmi LA, Matto OH, Caguimbay HJ. A Technical Innovation of Syringe Nipple Splint for Reconstructed Nipple.Nigerian J Plast Surg 2020;16:92-93


How to cite this URL:
Wani SA, Al Salmi LA, Matto OH, Caguimbay HJ. A Technical Innovation of Syringe Nipple Splint for Reconstructed Nipple. Nigerian J Plast Surg [serial online] 2020 [cited 2022 Jul 3 ];16:92-93
Available from: https://www.njps.org/text.asp?2020/16/2/92/303835


Full Text



The endpoint of long journey of patients with breast cancer is reconstruction of nipple. Techniques for reconstruction of nipple are numerous. Each technique is a favorite to individual plastic surgeon. Reconstruction of nipple by using local flapsis is now the most common method.[1] Lack of lasting projection is their greatest limitation.[2] This is related to both extrinsic and intrinsic mechanical forces acting on these flaps.

Use of postoperative splint of the reconstructed nipple is used with the aim to protect it from mechanical forces. A wide variety of splints have been described including nipple specfic plastic guards,[3] donut-shaped sponges, silicone-based nipple shields, suction devices, and modified occular shields.[4] All these dressing splints require to be ordered specifically. Some of them can cause compression of reconstructed nipple.

On the basis of our experience with a well-tried and documented technique using syringe-in-syringe design,[5] we describe a simpler modification of syringe nipple splint that is both quick and easy to assemble in operating room.

A no. 10 blade is used to cut lower 3 cms of 20 mL syringe. Four suspension sutures of 3-0 polypropylene are passed through the apex of reconstructed nipple at four corners, these suspension sutures are kept long. The base of the reconstructed nipple is covered by Steri strips. The cut piece of the syringe is placed to house the reconstructed nipple. The suspension sutures are passed over the top edge of the syringe splint and fixed to outer wall of syringe by using Steri strips. [Figure 1],[Figure 2],[Figure 3]{Figure 1}{Figure 2}{Figure 3}

Care is required to prevent excessive traction by overtightening the suture. Once the syringe splint is in place, fluff gauze is placed over the syringe to allow bra to be applied.

This open top end of chamber allows for inspection of the reconstructed nipple. This splint is kept in place for 2 weeks. Removal of splint is done by cutting suspension sutures.

This method of splinting the reconstructed nipple is a robust method, which is quick, cheap, and easy to perform. We recommend this method to be used for reconstructed nipples to avoid loss of projection.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Winocour S, Saksena A, Oh C et al. A systematic review of comparison of autologous, allogenic, and synthetic augmentation grafts in nipple reconstruction. Plast Reconstr Surg 2016;137:14e-23e.
2Sisti A, Grimaldi L, Tassinari J et al. Nipple −areola complex reconstruction techniques: a literature review. Eur J Surg Oncol 2016;42:441-65.
3Rosing JH, Momeni A, Kamperman K et al. Effectiveness of the Asteame Niipple Guard in maintaining projection following nipple reconstruction: aprospective randomised controlled trial. J Plast Reconstr Aesthet Surg 2010;63:1592-6.
4Sircar T, Chouhan A, Jori A. Cartella eye-shield as a dressing after nipple reconstruction: a techncal innovation. Ann R coll Surg Engl 2010;92:439-40.
5Choudhary S, Curnier A. "Syringe in Syringe" nipple splint. Plast Reconstr Surg 2002;109:1745-46.