Background: The COVID-19 pandemic caused unprecedented delays in elective surgery, including breast reconstruction, prolonging expander retention beyond recommended timelines. Methods: We retrospectively compared patients who underwent two-stage expander-to-implant reconstruction before the pandemic (2011–2020) and during the pandemic (2020–2022). Clinical outcomes and patient-reported experiences were analyzed, and multivariate regression was used to adjust for confounders. Results: Expander retention was significantly longer in the pandemic cohort (481 vs. 280 days). Capsular contracture around the expander was markedly increased, with pandemic group assignment and prolonged expander retention emerging as independent predictors in multivariate analysis, while overall complication rates were unaffected. Patient-reported outcomes showed more functional limitations but paradoxically higher satisfaction with the definitive implant. Conclusions: Surgical delay selectively increased the risk of expander contracture without raising overall morbidity. Patient-reported findings highlight the dual impact of delay, with both greater burden and a potential “relief effect”.
Wound complications such as delayed healing and infection remain a challenge in on-coplastic breast surgery, often prolonging recovery and affecting patient comfort. This study explored the use of innovative breast-shaped polyurethane and polyester dressings impregnated with an oxygen-enriched oleic matrix designed to release reactive oxygen species that support natural tissue repair. Sixty patients undergoing unilateral qua-drantectomy with contralateral breast remodeling were included. The advanced dressing was applied to the oncologic breast, while standard premedicated patches were used on the opposite side, allowing each patient to serve as their own control. Over the first po-stoperative month, outcomes such as wound dehiscence, infection, delayed healing, and user experience were assessed. The new dressing provided excellent skin hydration, comfort, and ease of use, with complication rates comparable to traditional treatments. No infections, hematomas, or reoperations were observed. Healthcare personnel reported that the device was simple to handle and replace, while patients appreciated the comfort and absence of adhesive irritation. These preliminary findings suggest that oxygen-enriched oleic matrix breast-shaped dressings offer a safe, practical, and pa-tient-friendly alternative for postoperative care in oncoplastic breast surgery. Larger prospective studies are warranted to confirm their potential in improving healing quality and patient experience.
Wound-related issues such as delayed healing and patient discomfort remain common challenges in oncoplastic breast surgery and may negatively affect early postoperative recovery. This single-centre, retrospective, within-patient study explored the feasibility and safety of a breast-shaped polyurethane and polyester dressing impregnated with an oxygen-enriched oleic matrix, designed to provide a controlled, low-level release of reactive oxygen species involved in physiological tissue repair. Sixty patients undergoing unilateral lumpectomy with contralateral breast remodelling were included. The advanced dressing was applied to the oncologic breast, while standard premedicated patches were used on the contralateral side, allowing each patient to serve as her own control. Early postoperative outcomes, including wound dehiscence, infection, delayed healing, and qualitative user experience, were assessed descriptively over the first postoperative month. The oxygen-enriched oleic matrix dressing was well tolerated and associated with good skin hydration, comfort, and ease of use. No infections, hematomas, or reoperations were observed, and no relevant differences in early complication patterns emerged between the treated and control sides. Both patients and healthcare personnel reported favourable handling characteristics and comfort, with no device-related adverse events. These preliminary, hypothesis-generating findings suggest that oxygen-enriched oleic matrix breast-shaped dressings are a feasible and safe option for early postoperative wound management in oncoplastic breast surgery. Prospective, adequately powered multicentre studies are warranted to further investigate their potential role within standardized postoperative care pathways.
Extremity soft tissue sarcoma resection often results in complex defects requiring reconstruction to preserve function and support multidisciplinary treatment. Propeller flaps have emerged as a local alternative to free flaps in selected cases, but their role in sarcoma reconstruction remains incompletely defined. This systematic review aimed to assess the current evidence on the indications, reconstructive outcomes, and oncologic reporting of propeller flaps in extremity sarcoma reconstruction. A systematic literature search was conducted in PubMed/MEDLINE, Scopus, and the Cochrane Library in accordance with PRISMA 2020. Studies reporting perforator-based propeller flaps after extremity soft tissue sarcoma resection were included. Data were synthesized descriptively because of the heterogeneity of study design, patient populations, and outcome reporting. Nineteen studies were included. Across the published literature, 656 patients were described overall, including 185 propeller flaps used after sarcoma resection. Most reconstructions involved the lower extremity, accounting for more than 95% of reported cases. Flap survival was generally high; among studies providing extractable numerical data, complete flap survival was 92.7% (115/124), total flap loss was 3.8% (2/52), and partial necrosis occurred in 9.6% (5/52) of flaps. Venous congestion was the most frequently reported complication. Oncologic outcomes were inconsistently reported, and comparative recurrence-related data were very limited. Available data suggest that propeller flaps can provide reliable coverage with acceptable complication rates in selected cases. Oncologic outcomes were sparsely and inconsistently reported, and the current literature does not show a clear signal of increased local recurrence; however, the available evidence is insufficient to draw firm conclusions regarding oncologic safety or equivalence compared with other reconstructive strategies. These findings support consideration of propeller flaps as a complementary reconstructive option in carefully selected patients, although higher-quality studies with standardized oncologic outcomes are needed.