{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T13:21:57Z","timestamp":1773926517954,"version":"3.50.1"},"reference-count":32,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The aim of this retrospective cohort study was to determine the frequency of early-stage nipple necrosis and wound complications in patients undergoing unilateral skin-sparing mastectomy (SSM) and direct implant-based reconstruction and describe the conservative\/advanced wound care approaches used for these complications. Materials and Methods: A retrospective review was made of the medical records of 84 patients who underwent same-session unilateral SSM and implant-based reconstruction in the Surgical Oncology Clinic between November 2019 and February 2024. Statistical analyses were performed using the Shapiro\u2013Wilk test, Mann\u2013Whitney U-test, and Chi-square\/Fisher tests. Results: The mean age of the patients was 43.51 \u00b1 6.5 years, 35.7% of the patients received neoadjuvant chemotherapy, and smoking prevalence was 7.1%. Wound complications developed in 16.7% of the patients, distributed as follows: wound dehiscence 6%, NAC necrosis 8.4%, infection 1.2%, and hematoma 1.2%. Interventions due to complications were performed at rates of 2.4% for areola excision, 2.4% for debridement, and 2.4% for implant excision. The only variable significantly associated with complication development was excision volume, which was higher in the complication group (p = 0.033). Logistic regression analysis showed that a one-unit increase in excision volume was associated with a statistically significant increase in the likelihood of complication development (O.R = 1.002; 95% CI: 1.000\u20131.004; p = 0.019). No significant association was found between age, height\/weight, neoadjuvant therapy, smoking, breast side, pathology subtype, axillary approach, and the development of complications (p &gt; 0.05). Advanced wound management was provided in 10 of the 14 cases (71.4%) that developed complications. Conclusions: Excision volume was found to be the only variable associated with wound complication development after implant-based reconstruction following unilateral SSM. Most complications were managed successfully with advanced wound care, minimizing the need for re-operation. For patients undergoing high-volume excision, risk-based early multidisciplinary, close follow-up is recommended.<\/jats:p>","DOI":"10.3390\/medicina62030575","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T08:54:37Z","timestamp":1773910477000},"page":"575","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Management of Nipple Necrosis and Wound Complications in Patients Undergoing Unilateral Skin-Sparing Mastectomy and Implant-Based Reconstruction for Breast Cancer: A Retrospective, Single-Center Study"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0464-8934","authenticated-orcid":false,"given":"Simay","family":"Akyuz","sequence":"first","affiliation":[{"name":"Department of Oncology Nursing, Gulhane Faculty of Nursing, University of Health Sciences, 06020 Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0441-0333","authenticated-orcid":false,"given":"\u015eevket Bar\u0131\u015f","family":"Morkavuk","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Gulhane Research and Training Hospital, University of Health Sciences, 06020 Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8967-7303","authenticated-orcid":false,"given":"Mehmet Ali","family":"G\u00fcl\u00e7elik","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Gulhane Research and Training Hospital, University of Health Sciences, 06020 Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"ref_1","unstructured":"(2025, November 16). 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