To explore the application of nipple repair surgery in the treatment of chronic nipple injury during lactation.

According to the inclusion and exclusion criteria, 274 patients with chronic nipple injury during lactation in the Haidian Maternal and Child Health Hospital from November 2015 to June 2020 were included for a retrospective analysis. Based on different treatment schemes, they were divided into 3 groups: the nipple repair group (87 cases) receiving nipple repair, the recombinant human basic fibroblast growth factor(rh-bFGF) application group (92 cases) receiving external application of drugs including rh-bFGF and the combined therapy group (95 cases) who firstly underwent nipple repair, and then applied rh-bFGF after operation. The non-parametric Kruskal-Wallis H test was used to compare the healing of nipple injury and pain improvement among three groups and the Dunn-Bonferroni test was used for pairwise comparison.χ² test was used to compare the recovery rate and recurrence rate, and Bonferroni correction of χ² test was performed for pairwise comparison.

The number of patients with complete healing of nipple injury, improvement of wound and inefficacy was 45, 22 and 20 in the nipple repair group, 33, 17 and 42 in the rh-bFGF application group, 70, 14 and 11 in the combined therapy group, indicating a significant difference (χ²=32.252, P<0.001). The healing of nipple injury in the combined therapy group was significantly better than that in the nipple repair group, and both the combinedtherapy group and the nipple repair group showed significantly better injury healing compared with the rh-bFGF application group (Bonferroni-corrected P=0.018, <0.001, 0.014). The number of patients with complete pain relief of nipples, partial relief and no relief was 40, 25 and 22 in the nipple repair group, 26, 29 and 37 in the rh-bFGF application group, 61, 21 and 13 in the combined therapy group, indicating a significant difference among three groups (χ²=26.907, P<0.001). The pain relief of nipples in the combined therapy group was significantly better than that in the nipple repair group, and both the combined therapy group and the nipple repair group showed better pain relief compared with the rh-bFGF application group (Bonferroni-corrected P=0.041, <0.001, 0.026). The recovery rate was 44.8% (39/87) in the nipple repair group, 26.1% (24/92) in the rh-bFGF application group and 55.8% (53/95)in the combined therapy group, indicating a significant difference among three groups(χ²=17.688, P<0.001). The recovery rate in the nipple repair group and the combined therapy group was significantly higher than that in the rh-bFGF application group (χ²=17.470, 7.149, Bonferroni-corrected P=0.008, <0.001), while there was no significant difference between the nipple repair group and the combined therapy group (χ²=2.183, Bonferroni-corrected P=0.140). The recurrence rate in the healed patients was 28.2% (11/39) in the nipple repair group, 29.2% (7/24) in the rh-bFGF application group and 24.5% (13/53)in the combined therapy group, indicating no significant difference among three groups (χ²=0.247, P=0.884).

For patients with chronic nipple injury during lactation, nipple repair surgery can improve the healing environment, relieve nipple pain and promote the efficacy of rh-bFGF in restoring the epithelia, tissues and nerves.