Introduction Infection is one of the most common complications of breast reconstruction. The presence of bacterial biofilm on the implant surface does not always manifest itself clinically as an infection. Still little is known about the factors that trigger the transition from a normal to a...

Background: Breast cancer is the most common cancer among women. The number of cases is increasing among young women, and consequently, breast reconstructions are performed more often. Postoperative complications, wound healing, and the quality of scars influence the final cosmetic outcomes. The aim of the study was to investigate the effect of using a negative-pressure therapy compared to a standard dressing on two postoperative wounds in the same woman, after bilateral tissue expander replacement surgery—when identical healing conditions occur. Methods: This study includes a single-center evaluation of the application of two different dressings during bilateral exchanges of tissue expanders with breast implants. The study included 22 patients with a history of breast cancer after bilateral mastectomy with two-stage reconstruction. During the second stage, a sNPWT was applied to one breast and a standard dressing to the other. Results: A statistically significant difference in skin elasticity in favor of sNPWT was visible after 7 days, while the greatest difference was visible in the evaluation after 6 months (mean of 0.806 vs. 0.607). A difference in temperature measurements was shown 7 days after the procedure. However, after 30 days, these measurements were similar. There was also a reduced incidence of postoperative complications as well as seroma accumulation in the breasts with negative pressure. Conclusions: The results indicate faster healing, better scar quality, and improved skin elasticity in breasts with sNPWT compared to the standard dressing. The number of postoperative complications were also reduced, which is especially important in high-risk patients.

Indroduction: Breast cancer is the most frequent cancer among women. Nowadays, more and more women decide to undergo breast reconstruction using both implants and autologous flaps. The most important factor in avoiding bad wound healing is the preservation of blood supply and good tissue perfusion. Latissimus dorsi (LD) flap reconstruction is a commonly used method, mainly reserved for irradiated patients, delayed reconstructions, or salvage procedures. With damaged tissues, objectively assessing the conditions is much more difficult than in primary surgery.Aim: The aim of the study is to present the intraoperative application of indocyanine green (ICG), in breast reconstructive surgery with a LD flap, as a preventive factor for tissue ischemia and postoperative complications.Materials and methods: A single-center retrospective review of the outcomes of 12 patients who underwent breast reconstruction using an LD flap, with an intraoperative assessment of flap blood supply using ICG. Patient characteristics, comorbidities, and smoking habit were taken into account.Results: In two cases, after an initial assessment of tissue perfusion, it was decided to resect the distal part of the flap with less blood supply. All reconstructions were successful and the wounds healed properly. None of the patients required reoperation and there were no postoperative complications or surgical site infections.Conclusions: The use of ICG in breast reconstruction with an LD flap is an important predictor of postoperative complications, especially flap necrosis and loss of reconstruction.

Breast reconstruction is a key step in the physical and social recovery of breast cancer patients. Optimal wound healing is crucial not only for aesthetic outcomes but also for the uninterrupted continuation of adjuvant oncologic therapy, which can significantly impact overall prognosis. The study compared single-use negative pressure wound therapy (sNPWT) with standard dressings during the second stage of breast reconstruction - tissue expander-to-implant exchanges. Additionally, it aimed to identify factors associated with an increased risk of impaired wound healing and postoperative complications, to determine clinical conditions in which the prophylactic use of sNPWT is most beneficial. The study evaluated 38 women undergoing the second stage of two-stage breast reconstruction after unilateral mastectomy. Each patient received either sNPWT or a standard dressing postoperatively, with allocation randomized and independent of both physician and patient. Scar characteristics, including elasticity, temperature, healing, and appearance, were assessed. A significant difference in skin elasticity in favor of sNPWT was observed after 7 days, while the most pronounced difference was seen after 6 months (mean 0.688 vs. 0.480). No significant differences were found in temperature. Visually, sNPWT-treated scars appeared narrower and less prominent. The mathematical model identified radiotherapy as the only factor significantly associated with poor healing (p-value = 0.025). Compared to standard dressings, sNPWT demonstrates clear advantages in improving scars' elasticity and aesthetic appearance. Its application significantly reduces postoperative complications, including the risk of implant loss, making it a valuable option in breast reconstruction.

Introduction: Gold standard treatment for locally advanced esophageal cancer is subtotal resection of the esophagus with resection of regional lymph nodes. Despite being performed in experienced and specialized centers, this procedure is associated with a high rate of complications. Complications such as anastomotic fistula and leakage can be life-threatening, primarily resulting from inadequate blood circulation in the anastomosis area. Aim: The aim of the study is to present the results of intraoperative indocyanine green (ICG) application in order to verify the adequate perfusion in esophagogastric anastomosis. Materials and methods: This is a single-center prospective analysis of 32 patients who underwent subtotal esophagectomy with regional lymph node resection for esophageal carcinoma. In all cases, intraoperative perfusion assessment using ICG fluorescence imaging (ICG-FI) was performed. Patient characteristics, comorbidities, and postoperative outcomes were analyzed, with treatment effects monitored for up to 1 year postoperatively. Results: Six patients required gastric conduit reduction due to poor blood perfusion visualized by intraoperative ICG-FI. Anastomotic leakage occurred in two cases, which were managed endoscopically with endo-vac therapy and esophageal stent placement. The remaining patients did not require additional surgical interventions during the postoperative course. Conclusions: The use of ICG dye in esophageal surgery appears to be a beneficial tool for objective assessment of perfusion that may be a valuable prediction factor in the postoperative course.