ArticleFrontiers in oncology2026
Are thin flaps still a contraindication? Early outcomes of prepectoral DTI reconstruction in a large single-center cohort.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Prepectoral direct-to-implant (DTI) breast reconstruction has gained popularity due to reduced morbidity and improved aesthetic and functional outcomes. However, thin mastectomy flaps (<1 cm, R1 following the Rancati classification) are traditionally considered at higher risk of complications, often leading surgeons to prefer subpectoral or staged approaches. This study evaluates whether prepectoral DTI reconstruction can be safely performed in patients with thin mastectomy flaps, challenging the traditional view that these patients are unsuitable candidates. Materials and methods: A retrospective single-center analysis was conducted on 1239 patients undergoing immediate prepectoral DTI breast reconstruction after nipple-sparing (NSM), skin-sparing (SSM), or skin-reducing mastectomy (SRM) between August 2018 and June 2025 (1663 mastectomies). Patients with prior radiotherapy were excluded. Intraoperative flap thickness was categorized as Group 1 (5-6 mm), Group 2 (7-9 mm), and Group 3 (≥ 10 mm). The primary endpoint were early postoperative complications (<30 days), classified as major or minor. Results: Overall, 152 mastectomies (9.14%) developed early complications. Complication rates were comparable across flap-thickness groups (Group 1: 10.48%, Group 2: 9.57%, Group 3: 8.66%; p = 0.704). Rates of wound dehiscence, infection, implant extrusion, and minor complications did not significantly differ among the groups. Ischemic complications requiring revision were more frequent in thinner flaps (2.1% in Group 1 vs. 0.51% and 0.43% in Groups 2 and 3), although absolute numbers remained low. Periprosthetic seromas showed a statistically significant but clinically modest difference. Conclusions: Flap thickness alone is not an independent predictor of early morbidity in prepectoral DTI reconstruction. When intraoperative perfusion is adequate and a standardized protocol is used, even flaps <1 cm can be safely subjected to DTI prepectoral reconstruction. These findings support expanding prepectoral indications to selected patients with thin mastectomy flaps.
Indexed as
Identifiers
What Socratic holds
Registered trials
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 Socratic graph.