Triple Flap Nipple Reconstruction Template
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Solution Overview
Problem
Current nipple reconstruction techniques face challenges in achieving accurate and efficient blood perfusion, leading to increased postoperative complications and decreased nipple projection over time, especially in cases with previous radiation therapy.
Innovation Solution
A template device and surgical method for creating a triple flap design in nipple reconstruction, where the template marks incision lines on the skin to define three flaps with a larger base interface, allowing for improved blood perfusion and tissue healing, involving preoperative marking, de-epithelization, and suturing of triangular areas to form a cylindrical nipple shape.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Device complexity
If a single pedicled flap is used for nipple reconstruction, then the surgical procedure is simple, but blood perfusion is insufficient leading to higher complication rates
Solution Approach 1:
The single flap is divided into three separate pedicled flaps, each with its own blood supply pathway. This segmentation allows multiple independent blood flow routes to reach the reconstructed nipple tissue, improving overall perfusion and reducing the risk of complete flap failure.
Solution Approach 2:
Each of the three flaps is designed with specific dimensional characteristics (base width greater than half the flap length) to optimize local blood flow distribution. The flaps are positioned to create overlapping vascular territories, ensuring uniform blood perfusion across the entire reconstructed nipple area.
2Ease of operation
If traditional flap designs are used, then the surgical technique is straightforward, but nipple projection decreases over time
Solution Approach 1:
The triple flap design creates three separate tissue pillars that are sutured together to form the nipple structure. This segmented construction maintains internal structural support and projection better than a single homogeneous flap, as each flap acts as an independent structural element.
Solution Approach 2:
The flaps are designed and positioned in three-dimensional space with specific orientation and depth considerations. The base of each flap is positioned deeper in the tissue while the free edge forms the nipple surface, creating a conical projection that maintains its shape over time through spatial configuration.
3Reliability
If radiation therapy is administered to treat breast cancer, then cancer treatment is effective, but postoperative complications increase and healing is impaired
Solution Approach 1:
The triple flap design creates multiple localized blood supply pathways that are distributed across different tissue regions. This distribution strategy ensures that if one flap's blood supply is compromised by radiation damage in a specific area, the other flaps can still receive adequate perfusion from different vascular territories.
Solution Approach 2:
The design incorporates redundant blood supply pathways before any complications occur. The three flaps are arranged to overlap in their vascular territories, creating a buffer system where healthy vascular regions can compensate for radiation-damaged areas, cushioning against the harmful effects of radiation on flap survival.
Data Source
AI summary
A triple flap nipple reconstruction is shown with preoperative incision markup lines guided by a template. The incision lines made on a patient's skin rims of flaps that are to form a reconstructed nipple. The marked-up lines define three flaps where each flap has one side in common with each of the other two flaps and also has one side in common with a part of the skin which is to be removed or de-epithelized. Also, the marked-up lines define parts of the patient's skin to be removed or de-epithelized. The surgical method thus consists of making the markup with the template with three single pedicled local dermal-fat flaps from the patient's skin and then de-epithelizing designated areas of the patient's skin, making incisions and forming, i.e., raising three flaps, forming base and elevating nipple by joining sides of de-epithelized areas, and jointing the three flaps.