Wong Allen Wei-Jiat, Chew Khong-Yik, Tan Bien-Keem
Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore.
Arch Plast Surg. 2017 Sep;44(5):449-452. doi: 10.5999/aps.2017.44.5.449. Epub 2017 Sep 15.
The nipple-sharing technique for nipple reconstruction offers excellent tissue matching. The method used for nipple graft harvesting determines the quality of the graft and hence, the success of nipple sharing. Here, we described a guillotine technique wherein the nipple is first transfixed with 2 straight needles to stabilise it. Two No. 11 blades are then inserted in the center and simultaneously swept outwards to amputate the distal portion of the nipple. This technique provides good control, resulting in a very evenly cut base. The recipient bed is deepithelialized thinly, and the nipple graft is inset with interrupted 8-0 nylon sutures under magnification. Being a composite graft, it is protected with splint dressings for 6 weeks, and the dressing is regularly changed by the surgeon. The height of the nipple grafts ranges from 4 to 8 mm. This technique was performed in 9 patients with an average follow-up of 2.9 years (range, 1-4.5 years). Apposition between the nipple graft and its bed is crucial for the success of this technique. When correctly applied, we observed rapid revascularization of the graft.
乳头重建的乳头共享技术可实现出色的组织匹配。用于获取乳头移植物的方法决定了移植物的质量，进而决定了乳头共享的成功率。在此，我们描述了一种断头台技术，即首先用两根直针贯穿乳头以使其稳定。然后将两片11号刀片插入乳头中心并同时向外扫动，以切除乳头的远端部分。该技术操作可控性好，可使乳头基部切割非常均匀。受区创面进行薄层去上皮处理，乳头移植物在放大条件下用8-0尼龙间断缝合固定。作为复合移植物，用夹板敷料保护6周，由外科医生定期更换敷料。乳头移植物的高度为4至8毫米。该技术应用于9例患者，平均随访2.9年（范围1至4.5年）。乳头移植物与其床面的贴合对该技术的成功至关重要。正确应用时，我们观察到移植物迅速再血管化。
