WIXLIB

Directions for UseDirections for UseNATRELLE Re-SterilizableBreast ImplantSizers

CAUTION: U.S. Federal law restricts this device to sale by or on theorder of a licensed physician.

Re-sterilizable Breast Implant SizersSTYLES INCLUDEDLocation of Orientation MarksNATRELLE 410 RE-STERILIZABLE BREAST IMPLANT SIZERNATRELLE 410 Smooth Silicone Gel-Filled Re-sterilizable Sizer.Posterior View (6 Marks)Posterior View (5 Marks)Anterior ViewFIGURE 1NATRELLE ROUND RE-STERILIZABLE BREAST IMPLANT SIZERNATRELLE Smooth Silicone Gel-Filled Re-sterilizable Sizer.INDICATIONSNATRELLE Re-sterilizable Round Silicone Breast Implant Sizers areused during breast augmentation or reconstruction procedures to assistthe surgeon in determining the appropriate size of a breast implant touse. Prior to using the NATRELLE Re-sterilizable Sizer, the physicianshould be familiar with all of the literature associated with the breastprosthesis to be implanted.CONTRAINDICATIONSRefer to the Round Silicone Breast Implant Directions for Use forinformation on contraindications.DESCRIPTIONNATRELLE Re-sterilizable Breast Implant Sizers are designed fortemporary intraoperative placement, to assist in determining thedesired breast implant volume. They are used during breastaugmentation or reconstruction procedures. The NATRELLE RoundRe-sterilizable Sizers are constructed from a smooth silicone elastomershell and are filled with responsive gel. The NATRELLE 410Re-sterilizable Breast Implant Sizers are constructed from a smoothsilicone shell and are filled with a gel that maintains the shape.The NATRELLE 410 and Round Re-sterilizable Sizers have beendesigned to match the NATRELLE Style 410 breast implants and theNATRELLE Round Silicone breast implants, respectively.NOTE: NATRELLE Re-sterilizable Breast Implant Sizers are suppliedsterile and intended for a maximum of ten additional reuses followingcleaning, disinfection and sterilization after each use. They are designedfor temporary use and should not be permanently implanted.WARNINGSRe-sterilizable Breast Implant Sizers are intended to be used only by aqualified surgeon. Before proceeding with surgery, the surgeon shouldinform the patient of the following warnings.1. RupturePatients should be advised that the Sizer may rupture, releasingsilicone gel into the surrounding cavity.Causes of rupture include: Damage by surgical instruments, such as nicks, slices,or puncture; Other trauma during surgery, such as improper handling ormanipulation.Do not insert or attempt to repair a damaged sizer.2.SIZER DESIGN FEATURES NATRELLE Re-sterilizable Sizers are supplied sterile and can bere-sterilized a maximum of ten times. NATRELLE 410 Re-sterilizable Sizers contain Soft Touch geland include orientation marks. (see Figure 1)3.1Infection, Necrosis, Hematoma/Seroma & PainInfection, necrosis, hematoma/seroma and pain, arecomplications which may occur following any type of surgeryand may require further investigation and treatment.Gel DiffusionMinute quantities of silicone may diffuse through the elastomerenvelope of the Sizer. NATRELLE Breast Implant Sizer shellsfeature a patented barrier coat between two layers of siliconeelastomer to minimize gel diffusion.

4.5.AlterationDO NOT alter the Re-sterilizable Sizer. Alteration to the originaldesign and fabrication voids all warranties, express or implied.NEVER, under any circumstances attempt to re-sterilize using ethyleneoxide, which is known to cause adverse tissue reaction if not completelyremoved from the device.Temporary DeviceHOW TO OPEN STERILE PRODUCT PACKAGERemove the Sizer from its packages in an aseptic environment and usingtalc-free gloved hands.DO NOT expose the Sizer to lint, talc, sponge, towel, skin oils or othersurface contaminants.1. Peel open the outer package.2. Invert the outer package over the sterile field, allowing the sealed innerpackage to gently fall into the field.3. Peel open the inner package.4. Gently retrieve the Sizer.Prior to use, keep the Sizer covered in the inner package, to preventcontact with airborne and surgical field particulate contaminants.NATRELLE Re-sterilizable Sizers are temporary devices, and arenot intended to be used as a permanent implant. They should only beused for temporary intra-operative placement, to assist the surgeonin permanent implant size selection.INSTRUCTIONS FOR USESURGICAL PROCEDUREAllergan relies on the surgeon to know and follow the proper surgicalprocedures with Silicone Gel-Filled Sizers. The surgeon can use theSizer to evaluate the correct implant size for each implantation. Planningshould include clear delineation of aesthetic goals to ensure mutualunderstanding between surgeon and patient. The surgeon should observecurrent and accepted techniques to minimize the risk of adverse, andpotentially disfiguring reactions.NOTE: Additional sizers of various sizes should be available to assistthe surgeon in determining the appropriate size.IMPORTANT: Please ensure that the serial number, lot number, andcatalogue number of device are recorded in all patient documentationand in the Sizer Re-sterilization Record to ensure productidentification and device traceability. The serial number is located onthe outer package label.PRODUCT IDENTIFICATIONProduct labels are supplied within the internal product packaging ofeach NATRELLE Re-sterilizable Sizer. The product labels providespecific information, which allows product identification. In additionto the product labels, a Sizer Re-sterilization Record Card is alsoprovided with the product for the recording of details of subsequentre-sterilization cycles carried out on the sizer.PRODUCT EXAMINATION PRIOR TO USEPrior to use, examine the Re-sterilizable Sizer for any evidence of damageor particulate contamination.DO NOT use any Re-sterilizable Sizer that may appear to have leaks,nicks or rupture.DO NOT use damaged or contaminated Re-sterilizable Sizers.DO NOT use Re-sterilizable Sizers that have been damaged or deformedduring previous surgical operations.REPEAT USEThese products are intended for ten (10) additional uses after initial useand only after adequate cleaning, disinfecting and re-sterilization byvalidated techniques.DO NOT reuse Re-sterilizable Sizers more than ten (10) times afterinitial use.DO NOT use disinfectant on the Re-sterilizable Sizer.Please ensure that a record of the reprocessing details of the Sizer isdocumented to ensure product identification and device traceability.SIZER PLACEMENTEnsure incision is sufficiently large to facilitate insertion and avoid damageto the device. The Sizer can be inserted/removed several times to assistwith size selection of the permanent implant.DO NOT damage the Re-sterilizable Sizer with sharp surgicalinstruments such as needles and scalpels, blunt instruments such asclamps and forceps, or by overhandling and manipulation duringintroduction into the surgical pocket.DO NOT contact the Sizer with disposable, capacitor-type cauterydevices as damage to the device may result.DO NOT use excessive force during placement of the Re-sterilizableSizer, especially with 410 Soft Touch gel-filled shaped Re-sterilizableSizers. Silicone gel may be deformed due to over manipulation, resultingin deformation of the anatomical shape.NOTE: Sizers are for sizing purposes only and are not for permanentimplantation.STERILE PRODUCTEach Sizer is supplied sterile in a sealed, double package. Sterility ofthe Sizer is maintained only if the packages, including the packageseals, are intact. Avoid prolonged exposure to extreme storageconditions. We recommend that these devices are stored at ambientroom temperatures, at atmospheric pressure and in dry conditions awayfrom direct sunlight.DO NOT use the product if the packages or seals have been damaged.DO NOT reprocess product under a non-validated procedure.2

METHOD FOR REMOVING RUPTURED GEL FROM THESURGICAL POCKETIn the event of Re-sterilizable Sizer rupture, the following technique isuseful for removal of the gel mass. Wearing double talc-free surgicalgloves on one hand, use the index finger to penetrate the gel mass.With the other hand, exert pressure on the breast to facilitatemanipulation of the gel mass into the double-glove hand. Once thegel is in hand, pull the outer glove over the gel mass and remove. Toremove any residual gel, blot the surgical pocket with gauze sponges.Avoid contact between surgical instruments and the gel. If contactoccurs, use isopropyl alcohol to remove the gel from the instruments.Ruptured Sizers must be reported and returned to Allergan. In the eventof Re-sterilizable Sizer rupture, contact Allergan’s Product SurveillanceDepartment at 1.800.624.42611.Gravity-Displacement CycleCycleEighteen (18)minutes minimumGravityDisplacement(Moist Heat):StandardTemperature121 2 C (250 4 F)Fifty (50)minutes minimumPulse Vacuum or Prevacuum CycleCycleNATRELLE Re-sterilizable Sizers are intended for a maximumten (10) additional uses after initial use following validatedprocedures for cleaning, disinfecting and re-sterilization. CompleteSizer Re-sterilization Record Card provided with the device aftereach re-sterilization process. The name of person performing there-sterilization and date of re-sterilization should be recorded on thecard. The Sizer Re-sterilization Record Card should accompany thedevice at all times.Time134 2 C (273 4 F)2.INSTRUCTIONS FOR REPROCESSINGTemperatureGravityDisplacement(Moist Heat)PulseVacuum orPrevacuumCycleTemperaturePulseVacuumsTime134 2 C (273 4 F)4 at amaximumof 75 mBarEighteen(18)minutesminimumNOTE: NEVER, under any circumstances attempt to re-sterilizeusing ethylene oxide, which is known to cause adverse tissue reactionif not completely removed from the device.CLEANING PROCEDUREDirectly after use, hand wash silicone-filled Re-sterilizable Sizer for aminimum of three (3) minutes with an anionic-enzymatic type detergent,equivalent to a 2% Multi-Terge solution, which should be discardedafter each use. Rinse with warm (between 37 C and 43 C) runningdeionized water for a minimum of one (1) minute to remove residuals.Deionized water is the minimum acceptable level of water purity.Distilled, double distilled, reverse osmosis, distilled reverse osmosis, andwater for injection are also acceptable.DO NOT use disinfectant on the Re-sterilizable Sizer.The sterilization cycle above has been demonstrated effective whenthe Re-sterilizable Sizer mass to autoclave chamber volume ratio doesnot exceed 7100g/m3. Examples of mass to autoclave volume are:Maximum Total Mass of Sizers3600g2700g1800gSTERILIZATION PROCEDURE (INCLUDINGPRION PROCESS)Volume of Autoclave Sterilizer0.51m3 (18.0ft3)0.41m3 (14.5ft3)0.31m3 (10.9ft3)For example, in a 0.51 m3 sterilizer (18.0 ft3), no more than twelve 300gsizers (3600g of sizers) may be sterilized.Double wrap Re-sterilizable Sizer in suitable autoclave wrappingmaterial, such as CSR sterilization wrap, place in autoclave on openshelf and process under the following validated autoclave cycle beforesubsequent re-use:Allow Sizer device to dry in the autoclave until outer wrap is entirelydry. Drying time of 30 minutes has been validated, however, dryingtime will vary with load composition, and the exhaust efficiency of thesterilizer. The user should verify in their own facility the specified dryingtime with their specific equipment and loads. Longer drying times maybe used if the healthcare facility finds it necessary. The wrapped deviceshould be placed in a covered container to minimize collection of airbornecontaminants. Allow for complete cooling of Re-sterilizable Sizer aftersterilization and before subsequent re-use.After autoclaving, discoloration of the gel may occur and/or air bubblesmight appear in the gel. The formation of air bubbles inside the sizer is3