{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T13:01:54Z","timestamp":1781182914563,"version":"3.54.1"},"reference-count":31,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"KOVE Co., Ltd."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Nipple\u2013areolar complex (NAC) necrosis following nipple-sparing mastectomy (NSM) delays adjuvant therapy and compromises oncological outcomes. This retrospective propensity-matched cohort study compared continuous topical oxygen therapy (cTOT), hyperbaric oxygen therapy (HBOT), and standard care (SOC) in patients with NAC necrosis after NSM. Methods: Between January 2020 and August 2025, 213 patients with NAC necrosis after NSM at a single academic center met eligibility criteria (cTOT, n = 57; HBOT, n = 59; SOC, n = 97). Propensity score matching (1:1:1, 15 covariates, all standardized mean differences &lt; 0.1) yielded 57 matched triplets (171 patients). The primary outcome was time to complete epithelialization, with restricted mean survival time (RMST) at 56 days designated as a co-primary metric. Results: cTOT was associated with the fastest healing (mean 30.5 \u00b1 9.9 days vs. HBOT 36.4 \u00b1 9.0, p = 0.007, vs. SOC 45.1 \u00b1 10.6, p &lt; 0.001). RMST analysis demonstrated a mean gain of 14.0 unhealed days (95% CI, 10.5\u201317.5) for cTOT versus SOC. Eight-week healing rates were 98.2% (cTOT), 96.5% (HBOT), and 87.7% (SOC). Multivariable Cox regression identified cTOT as an independent predictor of accelerated healing (HR 4.61; 95% CI, 2.99\u20137.11; p &lt; 0.001), with results stable across incision-type and ptosis-grade sensitivity analyses. The treatment association was most pronounced in larger wounds (\u22652.0 cm2; HR 6.85; p for interaction = 0.018). cTOT patients also reported significantly lower pain and higher satisfaction, with no device-related discontinuations (0\/57). Conclusions: cTOT was associated with significantly accelerated NAC necrosis healing and, as a portable home-based therapy, may support oncological treatment timelines after NSM. The shorter time to adjuvant initiation observed for cTOT (continuous outcome) was not paralleled by a significant reduction in the &gt;6-week delay endpoint, which requires confirmation in multicenter randomized trials.<\/jats:p>","DOI":"10.3390\/cancers18121907","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T12:14:58Z","timestamp":1781180098000},"page":"1907","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Continuous Topical Oxygen Therapy Is Associated with Accelerated Nipple\u2013Areolar Complex Necrosis Healing Following Nipple-Sparing Mastectomy: A Propensity-Matched Three-Way Comparison"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9584-8201","authenticated-orcid":false,"given":"Hyung-Suk","family":"Yi","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho-Young","family":"Im","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Hyung","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung-Ui","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5625-0912","authenticated-orcid":false,"given":"Jin-Hyuk","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ku-Sang","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8073-5511","authenticated-orcid":false,"given":"Yoon-Soo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1177\/1090820X14528352","article-title":"Nipple-areolar complex ischemia after nipple-sparing mastectomy with immediate implant-based reconstruction: Risk factors and the success of conservative treatment","volume":"34","author":"Dent","year":"2014","journal-title":"Aesthet. 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