Jalini Lona, Lund Jonathan, Kurup Vijay
North Tees and Hartlepool University Hospital NHS Foundation Trust, United Kingdom.
Breast and Endocrine Surgeon, North Tees and Hartlepool University Hospital NHS Foundation Trust, United Kingdom.
World J Plast Surg. 2017 Jan;6(1):68-73.
Nipple creation using the C-V flap technique is often the final step in breast reconstruction. The aim of this study was to subjectively and objectively assess the cosmetic outcomes and satisfaction of patients undergoing C-V flap nipple reconstruction.
Subjective assessments of patient satisfaction with the neo-nipple were recorded by visual analogue scoring (VAS; 0-10). Objective measurements were performed using a calliper to measure nipple projection relative to the native breast. Descriptive data analysis was performed with differences in projection assessed with the Mann-Whitney test and mean and median VAS scores (with inter-quartile ranges; IQR) calculated to describe satisfaction.
Thirty-three C-V flap nipple reconstructions were performed. 87.9% received latissimus dorsi (LD) reconstructions with implants and 12.1% had transverse rectus abdominis muscle (TRAM) reconstructions. The median projection of reconstructed nipples was 4.7 mm (range 4-10.2 mm) at 4.6 years mean follow-up, which was not significantly different from the contralateral nipple (p = 0.34). Patient satisfaction was 9 (IQR: 8-10) with shape, 9 (IQR: 7.5-10) with projection, 5 (IQR: 2-9.6) with sensation, and 8.5 (IQR: 6-9.5) with symmetry. Median overall satisfaction was 9 (IQR: 8-10). Three patients had complete nipple loss, of whom two had undergone nipple piercing post procedure and none had received radiotherapy.
C-V flap nipple reconstructions provide a simple and reliable method to reconstruct the nipple that enhances confidence and perception of body image. Satisfaction was high with long-term outcomes in terms of projection equivalent to the contralateral breast.
采用C-V皮瓣技术进行乳头再造通常是乳房重建的最后一步。本研究的目的是主观和客观地评估接受C-V皮瓣乳头再造患者的美容效果及满意度。
采用视觉模拟评分法（VAS；0-10分）记录患者对新乳头的满意度主观评估。使用卡尺进行客观测量，以测量乳头相对于健侧乳房的突出度。进行描述性数据分析，用Mann-Whitney检验评估突出度差异，并计算平均和中位数VAS评分（及四分位间距；IQR）以描述满意度。
共进行了33例C-V皮瓣乳头再造。87.9%接受了背阔肌（LD）联合假体再造，12.1%进行了腹直肌横断肌皮瓣（TRAM）再造。平均随访4.6年时，再造乳头的中位数突出度为4.7mm（范围4-10.2mm），与对侧乳头无显著差异（p = 0.34）。患者对形状的满意度为9分（IQR：8-10），对突出度的满意度为9分（IQR：7.5-10），对感觉的满意度为5分（IQR：2-9.6），对对称性的满意度为8.5分（IQR：6-9.5）。总体满意度中位数为9分（IQR：8-10）。3例患者乳头完全缺失，其中2例术后进行了乳头穿孔，均未接受放疗。
C-V皮瓣乳头再造提供了一种简单可靠的乳头再造方法，可增强自信心和身体形象感知。在突出度方面，长期效果与对侧乳房相当，满意度较高。
