The Reversed Glove Sleeve: A Readily Available and Cost-effective Way to Achieve “No Touch” Breast Implant Insertion

Barker, Anthony; Law, Jenalean; Nicholson, Margaret F.; Collett, David J.; Deva, Anand K.

doi:10.1097/gox.0000000000002650

Cited by 11 publications

(6 citation statements)

References 14 publications

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“…However, plastic surgery inclusion in medical education curricula is minimal to absent at most medical schools. 2,3 We therefore recruited 31 medical students to participate in a 1-hour lecture…”

Section: Effectiveness Of a 1-hour Event On Medical Students' Percept...mentioning

confidence: 99%

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A Less Costly “No Touch” Technique: Iodine-Impregnated Adhesive Surgical Drape

Pflibsen¹,

Leach²,

Teven³

et al. 2021

Plastic &Amp; Reconstructive Surgery

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Section: Effectiveness Of a 1-hour Event On Medical Students' Percept...mentioning

confidence: 99%

“…Bacterial contamination has been attributed to contact between the breast implant and a patient’s skin. 1–3 To mitigate this risk, surgeons have advocated a “no-touch” technique. 2,3 Several no-touch methods exist, the most common of which consists of using a funnel to transport the implant into the breast pocket without coming into contact with skin.…”

mentioning

confidence: 99%

A Less Costly “No Touch” Technique: Iodine-Impregnated Adhesive Surgical Drape

Pflibsen¹,

Leach²,

Teven³

et al. 2021

Plastic &Amp; Reconstructive Surgery

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“…13 Currently, several techniques utilizing barriers to achieve no-touch have been published, such as double-implant loading, reversed glove sleeve, infusion containers, packaged implant cover, tissue expander-acellular dermal matrix (ADM)-self-retaining retractor, plastic sleeve, and the Keller funnel. [12][13][14][15][16][17] The Keller funnel is an FDA-approved class 1 prosthesis based on a nylon sleeve made of a transparent polymeric material with a hydrophilic coating that allows the implant to slide into the pocket. It contains standardized markings on the outside, which represent a specific diameter that can be cut based on implant size.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Keller Funnel Efficacy in “No Touch” Breast Augmentation and Reconstruction: A Systematic Review

Morkuzu

Özdemir

Leach

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Background: Breast augmentation is one of the most common aesthetic surgical procedures. Tissue expansion followed by permanent implants is the most frequent postmastectomy breast reconstruction method. Implant contamination remains a critical problem with these procedures‚ resulting in acute infection as well as capsular contracture. To reduce the risk of implant contamination, the “no-touch technique” utilizing the Keller funnel has been adopted by many surgeons. This systematic review aims to investigate the advantages of the Keller funnel method for breast augmentation–reconstruction. Methods: A systematic review of PubMed, Embase, the Cochrane database, and Google Scholar was performed between 2005 and 2021. All clinical-based, retrospective and prospective studies utilizing the Keller funnel method for breast implant insertion were selected. Results: Six studies were identified for evaluation: five were retrospective cohorts and one was a prospective trial. No randomized controlled trials were found. Outcomes reported included lower rates of capsular contracture (RR, 0.42; P = 0.0006; 95% CI, 0.25–0.69), shorter incision lengths (35.5 ± 2.1 mm), less insertion time (mean = 6 seconds), and decreased complications, and one paper reported ultimately greater patient satisfaction with outcomes (BREAST-Q Score: 92%). Conclusions: This review suggests that the Keller funnel is a useful method for no-touch breast augmentation and reconstruction surgery. The Keller funnel reduces subsequent capsular contracture rate, surgical time, and incision length and allows for easier insertion. However, our findings support recommendation of a prospective randomized controlled clinical trial with larger population size and follow-up intervals.

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“…3,4 These devices are sold as "single-use" and single-patient devices, 5 and are costly compared to other disposable breast augmentation supplies. Other devices or cost-efficient techniques made from commonly available medical supplies, such as sterile IV bags, 6 or sterile gloves 7 have not been widely adopted.…”

Section: Introductionmentioning

confidence: 99%

Higher Prevalence of Capsular Contracture with Second-side Use of Breast Implant Insertion Funnels

Bresnick

2021

Plastic and Reconstructive Surgery - Global Open

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Background: Breast implant insertion funnels have become popular adjuncts to breast implant surgery to reduce access incision length and contact of the implant with the skin of the breast. Although labeled as single-use devices, due to cost considerations, many surgeons use a new breast implant insertion funnel with each patient rather than each breast. The purpose of this study was to evaluate the prevalence of capsular contracture of the first augmentation side and compare it to the second side utilizing one insertion funnel per patient. Methods: Patients undergoing silicone breast augmentation or silicone augmentation mastopexy with smooth surface silicone implant and utilizing a breast implant insertion funnel were studied. Six hundred consecutive patients (1200 breasts) meeting the study criteria were evaluated. Memory Gel silicone breast implants were utilized for each patient and only patients undergoing augmentation with the same implant size were studied. Patients underwent augmentation with either inframammary or periareolar incisions. Results: A total of 27 capsular contractures were noted, a rate of 2.25%. The rate of capsular contracture was significantly higher with the second-side use of insertion funnels (P = 0.0179). Of the capsular contractures noted, 25.9% occurred on the first side, whereas 74.1% occurred on the second side. Capsular contracture rates were higher on the second side for both access incision locations. Capsular contracture prevalence increased with reuse of the same insertion funnel for the same patient. Conclusion: Based on these findings, surgeons should consider utilizing implant insertion devices as single-use, to minimize the capsular contracture risk.

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The Reversed Glove Sleeve: A Readily Available and Cost-effective Way to Achieve “No Touch” Breast Implant Insertion

Cited by 11 publications

References 14 publications

A Less Costly “No Touch” Technique: Iodine-Impregnated Adhesive Surgical Drape

A Less Costly “No Touch” Technique: Iodine-Impregnated Adhesive Surgical Drape

Keller Funnel Efficacy in “No Touch” Breast Augmentation and Reconstruction: A Systematic Review

Higher Prevalence of Capsular Contracture with Second-side Use of Breast Implant Insertion Funnels

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