Medical management of acute partial skin necrosis following nipple-sparing mastectomy using an M101-based oxygenating dressing: Two case reports

TL;DR

Two case reports show successful non-surgical treatment of skin necrosis after nipple-sparing mastectomy using an oxygenating dressing based on M101.

Contribution

Demonstrates the potential of M101-based oxygenating dressings as a novel treatment for post-NSM skin necrosis.

Findings

M101-based oxygenating dressing prevented the need for surgical debridement in two cases of partial skin-flap necrosis.

The treatment allowed for healing of the nipple–areola complex without requiring reoperation or implant loss.

Abstract

Postmastectomy skin-flap necrosis after nipple-sparing mastectomy (NSM) is common and exceeds rates after skin-sparing mastectomy (SSM) (0–19.5 %), influenced by patient factors and modifiable intraoperative variables. Presentations range from superficial necrosis to full-thickness necrosis requiring surgical debridement. These events drive reoperation or implant loss, may delay adjuvant therapy, and burden patients psychologically. Clinical examination and ancillary tests poorly discriminate depth; thus, management usually entails close observation until demarcation, followed by targeted intervention. M101, a hemoglobin-based oxygen carrier, demonstrates anti–ischemia–reperfusion effects and promise in advanced wounds. We report two NSM cases with partial skin-flap and nipple–areola complex necrosis managed with an M101-based oxygenating dressing (HemHealing®; Hemarina SA, Morlaix, France), with ultimately no surgical debridement required.

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