{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:05:14Z","timestamp":1789517114783,"version":"build-2803163510"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Immediate prepectoral breast reconstruction with polyurethane-coated implants provides esthetic and functional benefits compared with subpectoral techniques, but early postoperative complications remain a concern. Closed incision negative pressure wound therapy (ciNPWT) has demonstrated benefits in other surgical fields, though evidence in breast reconstruction is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate whether ciNPWT reduces early postoperative complications after immediate prepectoral reconstruction with polyurethane-coated implants, particularly in high-risk patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 620 patients undergoing unilateral or bilateral conservative mastectomy with immediate prepectoral reconstruction using polyurethane-coated implants between May 2021 and February 2024. Patients were divided into 2 cohorts: 257 treated with ciNPWT and 363 with conventional dressings. Subgroup analyses considered mastectomy flap thickness (0.5-0.6\u2005cm, 0.7-0.9\u2005cm, \u22651.0\u2005cm) and specimen weight (&amp;lt;500\u2005g vs \u2265500\u2005g). Early complications (\u226430\u2005days) were classified as major (requiring reoperation or hospitalization) or minor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>ciNPWT significantly reduced major complications compared with controls: wound dehiscence (1.17% vs 6.61%), flap ischemia (0% vs 2.2%), major infection (0.39% vs 2.48%), and implant extrusion (0.39% vs 2.2%). Minor complications, including periprosthetic seromas, were also reduced (4.28% vs 5.79%). The protective effect was most evident in patients with thin mastectomy flaps (0.5-0.9\u2005cm) and specimen weight \u2265500\u2005g. Correlation between intraoperative flap thickness and preoperative Rancati score confirmed benefits in high-risk patients (Rancati type 1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ciNPWT reduces early complications in immediate prepectoral reconstruction, with greatest benefit in high-risk patients. Integration into reconstructive protocols may enhance safety and broaden indications. Prospective randomized trials are warranted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence: 3 (Therapeutic)<\/jats:title>\n                    <jats:p>For image description, please refer to the figure legend and surrounding text.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/asj\/sjaf211","type":"journal-article","created":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T11:32:18Z","timestamp":1761046338000},"page":"1075-1083","source":"Crossref","is-referenced-by-count":1,"title":["Can the Use of Closed Incision Negative Pressure Wound Therapy in Immediate Prepectoral Breast Reconstruction With Polyurethane-Coated Implants Reduce the Rate of Early Complications?: A Comparative Study"],"prefix":"10.1093","volume":"46","author":[{"given":"Marzia","family":"Salgarello","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3042-7082","authenticated-orcid":false,"given":"Niccol\u00f2","family":"Lazzeri Domar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Visconti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5828-2851","authenticated-orcid":false,"given":"Lorenzo","family":"Scardina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0223-9635","authenticated-orcid":false,"given":"Sabatino","family":"D\u2019Archi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8219-5336","authenticated-orcid":false,"given":"Alba","family":"Di 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