Strattice reconstructive tissue matrix to maintain nipple projection—what do patients think?
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One of the main challenges in nipple reconstruction is achieving and maintaining nipple projection. We describe a novel use of banked Strattice to provide an internal scaffold and improve long-term projection following nipple reconstruction. We assess patient and partner satisfaction with the technique compared with routine reconstruction.
All patients who underwent nipple reconstruction in our unit by a single surgeon between 1/1/11 and 29/4/16 were identified retrospectively and asked to complete a satisfaction questionnaire relating specifically to their reconstruction. Those who underwent reconstruction with Strattice were compared with those that had local flaps alone.
Sixty-four patients and 73 nipples were reconstructed during the study period. Eighteen nipples were reconstructed on 14 patients using Strattice. Fifty-seven patients responded to the questionnaire (90.5%). One patient developed an infection requiring removal of the banked matrix. Patients had a statistically significant increased degree of satisfaction when Strattice was used to augment their reconstruction (Mean ± SEM score 8.06 ± 0.20 versus 5.83 ± 0.16 for no Strattice; p < 0.0001). This was also the case when undressed (7.59 ± 0.15 vs 5.69 ± 0.16) but did not reach statistical significance when the patient was dressed (6.85 ± 0.19 vs 6.44 ± 0.11; p = 0.08). Patients’ partners also rated the reconstruction more highly when Strattice was used (7.71 ± 0.14 versus 6.33 ± 0.19 for no Strattice).
Our study demonstrates that the use of Strattice in nipple reconstruction can lead to significantly increased rates of satisfaction among women undergoing the final stage of breast reconstruction.
Level of Evidence: III Therapeutic study.
KeywordsNipple reconstruction Nipple projection Patient satisfaction Strattice Dermal matrix
Compliance with ethical standards
Conflict of interest
Arvind Mohan, Honey Ghaffari, and Mark Ho-Asjoe declare that they have no conflict of interest.
For this type of study formal consent was not required. However, informed consent was obtained for photographic publication and prior to operative procedures.
No ethical approval was required in the production of this study.