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

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.