Evidence map›Paper›PMID 40298229›Full record

ArticleJournal of the American College of Surgeons2025

Nipple-Sparing Mastectomy and Infection Risk after Immediate Breast Reconstruction.

Margaret A Olsen, Katelin B Nickel, Julie A Margenthaler, Terence M Myckatyn, David K Warren

Abstract readMulticenter Study
In one paragraph

Article in Journal of the American College of Surgeons, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Margaret A OlsenFrom the Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St Louis, MO (Olsen, Nickel, Warren).
Katelin B NickelFrom the Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St Louis, MO (Olsen, Nickel, Warren).
Julie A MargenthalerDivisions of Surgical Oncology (Margenthaler) Washington University School of Medicine, St Louis, MO.
Terence M MyckatynPlastic and Reconstructive Surgery (Myckatyn), Washington University School of Medicine, St Louis, MO.
David K WarrenFrom the Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St Louis, MO (Olsen, Nickel, Warren).

Funding

Washington University Center for Cellular ImagingP30CA091842 · NCI · WASHINGTON UNIVERSITY · PI TIMOTHY J. EBERLEIN · 2001 to 2026
$128.0M
WU INSTITUTE OF CLINICAL AND TRANSLATIONAL SCIENCESUL1TR002345 · NCATS · WASHINGTON UNIVERSITY · PI William G. Powderly · 2017 to 2026
$97.8M
NCATS NIH HHS UL1 TR002345NCEZID CDC HHS U54 CK000609NCI NIH HHS P30 CA091842
6 · The paper itself

Abstract

backgroundWound complications are known to occur after nipple-sparing mastectomy (NSM), especially in procedures involving a periareolar incision. We sought to determine the independent risk of infection and overall wound complications associated with NSM vs skin-sparing mastectomy (SSM) in a contemporary cohort of women undergoing immediate implant reconstruction. STUDY

designWe identified 352 women 21 years of age or older undergoing mastectomy and immediate implant reconstruction from September 2021 to December 2022 using electronic health records from 2 hospitals. The relative risk (RR) of surgical site infection (SSI) and of serious wound complication (infection or noninfectious wound complication [NIWC; dehiscence or tissue necrosis] requiring surgical treatment in the operating room) within 180 days after surgery associated with NSM vs SSM was determined using a modified Poisson regression model, controlling for established risk factors for SSI.

resultsNSM was performed in 128 women (36.4%), most commonly via an inframammary fold incision (73.4%). SSI occurred in 49 (13.9%) women within 180 days after surgery, whereas 70 (19.9%) women developed an SSI or NIWC. Although the incidence of SSI and the composite SSI/NIWC outcomes was similar after NSM vs SSM (14.8% vs 13.4% and 21.1% vs 19.2%, respectively); in multivariable analysis, NSM was associated with increased risk of both SSI (RR 2.13, 95% CI 1.26 to 3.59) and SSI/NIWC (RR 2.19, 95% CI 1.40 to 3.43).

conclusionsNSM was associated with increased risk of both SSI and NIWCs requiring surgical treatment after controlling for other established risk factors, despite uncommon use in this cohort of a periaerolar incision. This information should be communicated to women at the time of presurgical counseling to facilitate shared decision-making.

Indexed as

Breast NeoplasmsMammaplastyMastectomy, SubcutaneousSurgical Wound InfectionAdultAgedFemaleHumansMiddle AgedNipplesRetrospective StudiesRisk FactorsYoung Adult

Identifiers

PMID40298229
PMCPMC12393666

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.