Postoperative Nipple-Areola Complex Monitoring: The “Trapdoor” Dressing

Abstract

Postoperative monitoring of the nipple-areola complex is a common procedure in breast surgery [1]. Following reconstructive and aesthetic surgery a compressive and stable dressing may be used in supporting the new shape of the breast [2]. During the postoperative period the dressing should be easily removable to check the nipple-areola complex viability. Many custom-made dressings, with more than one sterile drape or gauze, are used in many centers but very few are discussed in the literature. We introduce a simple, fast, practical, and easily reproducible dressing for postoperative monitoring of the nipple-areola complex. A double layer of sterile gauze is opened and folded in two specular layers, defining an anterior and a posterior layer (Fig. 1a, b). The posterior layer is folded in two other specular layers (Fig. 1c). A hole is made by an ovalar or triangular cut in the posterior layer (Fig. 1d–f). The posterior layer is applied over the nipple-areola complex and fixed to the skin using sterile tape (Fig. 2a, b). Leaving the dressing intact, the anterior layer can be used as a ‘‘trapdoor’’ to visualize the nipple-areola complex (Fig. 2c, d). The ‘‘trapdoor’’ dressing is very comfortable for the patients and very practical for the health care providers because it avoids dressing change and allows nipple-areola monitoring without affecting the sterile field. The dressing saves time and money and is also very easy to remove in case of bleeding or nonsterile contamination.