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A retrospective comparison evaluated consecutive patients receiving immediate prepectoral direct-to-implant reconstruction with Braxon® ADM (Oct 2019–Jan 2025) using standard full-wrap versus an anterior-only modified wrap with posterior trimming and anterior fenestrations. The modified approach showed lower overall complications (10.4% vs 27.8%, p=0.02) and reduced seroma rates (2.1% vs 8.9%).",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/a-new-way-to-wrap-innovative-adm-braxon-packaging-technique-reduces-seroma-in-prepectoral-breast-reconstruction/461621/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/a-new-way-to-wrap-innovative-adm-braxon-packaging-technique-reduces-seroma-in-prepectoral-breast-reconstruction/461621.png","ImageObject",300,407,{"name":92,"@type":93},"OmBimo","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What clinical problem does the study target in prepectoral breast reconstruction?","Question",{"text":112,"@type":113},"The study targets seroma formation and other postoperative complications associated with prepectoral implant reconstruction using ADMs.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What two Braxon® ADM wrapping techniques were compared?",{"text":117,"@type":113},"A standard full-wrap configuration was compared with a modified technique where the posterior ADM sheet is trimmed, only anterior coverage is maintained, and fenestrations are created in the anterior wall.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the main outcome differences between the standard and modified techniques?",{"text":121,"@type":113},"Overall complication rates were lower with the modified technique (10.4% vs 27.8%, p=0.02), and seroma occurred less often (2.1% vs 8.9%).","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},461621,1790816575,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},962090893581,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Article  \nA New Way to Wrap: Innovative ADM Braxon Packaging  \nTechnique Reduces Seroma in Prepectoral Breast Reconstruction  \nGiovanni Arrica 1,2, *, Corrado Rubino 1,2, Federico Ziani 1,2, Edoardo Filigheddu 1,2, Sofia De Riso 1,2, Gianluca Marcaccini 3, Roberto Cuomo 3, Claudia Trignano 4 and Emilio Trignano 1,2  \nAcademic Editor: Salvatore Giordano  \nReceived: 2 November 2025  \nRevised: 11 December 2025  \nAccepted: 17 December 2025  \nPublished: 19 December 2025  \nCopyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy;  \n[corubino@uniss.it](corubino@uniss.it) (C.R.); [zianifederico@gmail.com](zianifederico@gmail.com) (F.Z.); [edofili@gmail.com](edofili@gmail.com) (E.F.);  \nsofia.deriso@aouss.it (S.D.R.); etrignano@uniss.it (E.T.)  \n2 Plastic Surgery Unit, University Hospital Trust of Sassari, 07100 Sassari, Italy  \n3 Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy; [gianlu32@gmail.com](gianlu32@gmail.com) (G.M.); [robertocuomo@outlook.com](robertocuomo@outlook.com) (R.C.)  \n4 Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; [claudia.trignano@uniss.it](claudia.trignano@uniss.it)  \n* Correspondence: [giovanni.arrica@aouss.it](giovanni.arrica@aouss.it)  \nAbstract  \nBackground: In recent years, prepectoral implant-based breast reconstruction supported by acellular dermal matrices (ADMs) has become an increasingly adopted alternative to submuscular techniques. Although this approach can improve patient comfort and aesthetic outcomes, fluid accumulation around the implant remains one of the most frequent and clinically relevant complications. Our unit progressively modified the handling and wrapping of the Braxon® ADM with the aim of optimizing pocket configuration and reducing seroma formation. Methods: We performed a retrospective analysis of consecutive patients who underwent immediate prepectoral, direct-to-implant breast reconstruction with Braxon® ADM at our institution between October 2019 and January 2025 . Two techniques were compared: a standard full-wrap configuration and a modified approach in which the posterior ADM sheet is trimmed and only anterior coverage is maintained, with fenestrations created in the anterior wall. Clinical data and postoperative complications, including seroma rates, were recorded and compared between groups. Categorical variables were summarized as counts and percentages, and continuous variables as means and standard deviations. The primary comparison between techniques was performed on the presence of at least one postoperative complication using Fisher’s exact test, and odds ratios (OR) with 95% confidence intervals (CI) were calculated where appropriate. A p-value \u003C0.05 was considered statistically significant. Results: A total of 138 direct-to-implant prepectoral reconstructions were included, 90 performed with the standard full-wrap technique and 48 with the modified wrapping approach. The overall complication rate was 27.8%(25/90) in the standard group and 10.4%(5/48) in the new-technique group. Seroma occurred in 8 patients (8.9%) in the standard group and in 1 patient (2.1%) in the modified-technique group. Fisher’s exact test demonstrated a significantly lower overall complication rate in the modified-technique cohort (10.4% vs. 27.8%; p = 0.02; OR 3.31; 95% CI 1.18–9.31), indicating that patients treated with the standard technique had approximately 3.3-fold higher odds of developing at least one complication than those treated with the modified technique. Conclusions: Anterior-only ADM coverage with selective trimming of the posterior sheet and fenestration of the anterior wall appears to reduce complications, particularly seroma, in ","cbCaivfbjH1NdrzA","https://ap.wps.com/l/cbCaivfbjH1NdrzA","pdf",1227240,13,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusions\n# 1. Introduction","[{\"question\":\"What clinical problem does the study target in prepectoral breast reconstruction?\",\"answer\":\"The study targets seroma formation and other postoperative complications associated with prepectoral implant reconstruction using ADMs.\"},{\"question\":\"What two Braxon® ADM wrapping techniques were compared?\",\"answer\":\"A standard full-wrap configuration was compared with a modified technique where the posterior ADM sheet is trimmed, only anterior coverage is maintained, and fenestrations are created in the anterior wall.\"},{\"question\":\"What were the main outcome differences between the standard and modified techniques?\",\"answer\":\"Overall complication rates were lower with the modified technique (10.4% vs 27.8%, p=0.02), and seroma occurred less often (2.1% vs 8.9%).\"}]","A New Way to Wrap: Innovative ADM Braxon Packaging Technique Reduces Seroma in Prepectoral Breast Reconstruction | PDF",1790761994,33]