Reduction of potential contamination of breast implants by the use of 'nipple shields'

Forty-three breast implant operations in 25 patients were studied prospecti vely to determine the effectiveness of covering the nipple-areolar complex with an adhesive film dressing in preventing perioperative expression of ba cteria from nipple ducts contaminating the operative field. One swab from t he nipple after skin preparation and none of the swabs taken from the outer surface of the film dressing postoperatively yielded any bacterial growth. Fourteen breasts (33%) in 11 patients (44%) yielded bacterial growth from swabs under the film postoperatively. Six of 9 breasts (67%) in 5 patients who had capsulectomies had bacteria isolated from under the film postoperat ively. Ten of 14 (71%) control breasts (no shields) in 6 of 7 patients (86% ) had positive postoperative swabs. This study confirms the potential risk of bacterial contamination arising f rom nipple duct flora during intraoperative breast manipulation, and the ef fectiveness of a perioperative adhesive film placed over the nipple-areolar complex in preventing subclinical bacterial contamination of implanted bre ast prostheses.