title: Management of nipple-areolar complex complications in skin-sparing mastectomy with prosthetic reconstruction A case report.
abstract: Venous congestion of the NAC (Nipple-Areola Complex) is not an uncommon complication of Skin-Reducing Mastectomy (SRM). The correct and prompt evaluation of the NAC's vitality in the first hours after surgery is important for the survival of the same, in fact the possibility of early intervention allows avoiding the use of invasive and radicals techniques to the advantage of simpler rapid procedures.
  
  
  METHODS
  DM, 57yr, multiple invasive ductal carcinoma of the right breast, underwent a SRM and immediate reconstruction with implant in August 2014 In the immediate post-operative appeared a venous stasis of the NAC. Treatment started with Negative Pressure Wound Therapy (NWPT) through VAC-Systems to 75 mmHg.
  
  
  RESULTS
  The use of the VAC-Therapy was in total 12 days and allowed the partial rescue of the NAC (85%). the vacuum pump is put into a portable bag so the patient's mobility is not limited.
  
  
  CONCLUSIONS
  NWPT permitted a rapid resolution of NAC's complication in SRM in order to guarantee an optimal timing for the start of adjuvant chemotherapy. The VAC-Therapy is a cost effective and simple to use in cases of suffering venous NAC in patients undergoing breast surgery.
  
  
  BACKGROUND
  NAC, NWPT, Skin-Reducing Mastectomy, VAC-Therapy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Annacontini
authors.forename: Francesco
authors.initials: F
authors.lastname: Ciancio
authors.forename: Domenico
authors.initials: D
authors.lastname: Parisi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Innocenti
authors.forename: Aurelio
authors.initials: A
authors.lastname: Portincasa
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects* / Q000379:methods; D015414:Mastectomy, Subcutaneous / Q000009:adverse effects / Q000379:methods; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000379:methods; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009558:Nipples / Q000098:blood supply*; D019736:Prostheses and Implants; D000072836:Surgical Wound / Q000209:etiology* / Q000628:therapy*; D016896:Treatment Outcome