he rate of breast cancer has recently been increasing by 0.5% annually. 1 Rapid diagnosis and efficacy of neoadjuvant and adjuvant therapies have permitted an increase in Background: Breast cancer remains the most common nonskin cancer among women. Prophylactic methods for reducing surgical-site complications after immediate breast reconstruction (IBR) are crucial to prevent acellular dermal matrices or prosthesis exposure and loss. The authors assessed the impact of closed-incision negative-pressure wound therapy (ciNPWT) versus standard dressings (ST) after IBR on surgical-site complications, superficial skin temperature (SST), skin elasticity, and subjective scar quality, to determine the potential benefit of prophylactic ciNPWT application. Methods: A multicenter randomized controlled study of 60 adult female patients was conducted between January of 2019 and July of 2021. All patients had oncologic indications for IBR using implants or expanders. Results: Application of ciNPWT correlated with a significant decrease in surgical-site complications within 1 year of surgery (total, 40%; ST, 60%; ciN-PWT, 20%; P = 0.003) and resulted in more elastic scar tissue as measured with a Cutometer (average coefficient of elasticity, 0.74; ST, 0.7; ciNPWT, 0.9; P < 0.001). The SST of each scar 1 week after surgery was significantly higher in the ciNPWT group (average SST, 31.5; ST SST, 31.2; ciNPWT SST, 32.3; P = 0.006). According to the Patient and Observer Scar Assessment Scale v2.0, subjective scar outcomes in both groups were comparable. Conclusions: This is the first randomized controlled study that demonstrated a significant decrease in surgical-site wound complications within 1 year of surgery in IBR patients receiving ciNPWT. A high probability of postoperative radiotherapy should be a relative indication for the use of ciNPWT.

El verde de indocianina es un tinte que se ha utilizado en medicina durante varias décadas. Tiene una serie de aplicaciones, incluida la cirugía reconstructiva y las quemaduras. Permite detectar áreas de tejido con perfusión reducida, lo que reduce el riesgo de complicaciones postoperatorias en forma de procesos de cicatrización alterados y necrosis. La técnica de imágenes de fluorescencia que utiliza este tinte, permite observar los cambios en la fluorescencia en tiempo real que, se ha demostrado, ocurren entre las capas superficiales y profundas en las quemaduras. Esto permite un diagnóstico cualitativo y cuantitativo de la profundidad de la quemadura, lo que se traduce en la elección de un tratamiento adicional. Se aprecia la importancia particular de este método en la prevención de la necrosis cutánea con el complejo areola-pezón durante la reconstrucción mamaria simultánea. Se necesitan más ensayos controlados aleatorios prospectivos para considerarlo el "método de elección" en la práctica clínica.