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Use of SPY Elite System for Evaluation of Skin Flap Circulation Following
Anna Widmyer
Douglas Wagner
Summa Akron City Hospital
2017-02-15
Presenter: Anna Widmyer
Affidavit:
This abstract has not been presented at any other meetings and respresents the work of our resident Anna Widmyer
Director Name: Douglas Wagner
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background: Nipple necrosis or skin loss following nipple-sparing mastectomy (NSM) can be a devastating complication, and its incidence varies in the literature from 4.4-48%. Large, ptotic breasts and previous smokers have been identified as high risk patients for whom a nipple delay procedure is recommended. Our study looks to evaluate the usage of SPY Elite fluorescent imaging to evaluate flap quality and the success of delay procedure.
Methods: A retrospective review was performed on patients who underwent nipple delay procedure and subsequent nipple sparing mastectomy between January-December 2016.
Results: 11 patients (18 breasts) were identified fitting study criteria. SPY data was obtained before incision was made and at the conclusion of delay procedure. Immediately following the delay procedure the nipple areolar complex (NAC) underwent an average of 25% decrease on SPY evaluation. Subsequently at time of mastectomy, all patients had viable nipples despite further manipulation during mastectomy and implant placement. One nipple had residual LCIS which was re-excised, and one patient required excision of flap edge necrosis.
Conclusions: In this series, surgical delay of the NAC in high risk nipple-sparing mastectomy reconstruction resulted in successful nipple sparing mastectomies with no loss of NAC and SPY evaluation aided in confirming flap viability.
