The Incidence of and Risk Factors for Breast Infections After Tissue Expander Placement

Abstract Goals/Purpose Breast tissue expansion has a reported infection rate ranging from 2.4-25% in the literature when used for post mastectomy breast reconstruction. Expander infections may prolong reconstructive timeframe, increase costs, portend poorer aesthetic outcomes, and decrease patient satisfaction. Medical treatments are often attempted to salvage implants prior surgical treatment including irrigation, implant replacement, or explantation. The purposes of this study include 1) ascertain incidence patients with expanders at our institution, 2) explore success medical precluding explantation, 3) identify modifiable risk factors associated any post-expander infection, 4) requiring subsequent Methods/Technique A single-center, single-surgeon, 4-year retrospective review was performed. Patient demographics, comorbidities, techniques were extracted. Clinical defined by clinical evidence cellulitis abscess expander present, regardless presence absence systemic symptoms. Preservation following either antibiotics intervention considered salvage, whereas removal pocket closure explantation calculated separately. Chi-squared analysis both generalized estimated equations model account who had one infected how that might affect other future placement. It also odds ratios related identified previously. Results/Complications total 349 breasts 163 included cohort. There 17.1% cohort 12.9% secondary infection. Of breasts, 24.6% managed alone. Significant chest radiation (p=0.021; OR 3.73, CI95% 1.22-11.34) use immune modulating drugs (p=0.012; 2.81, 1.25-6.30). age (p=0.030), volume (p=0.038), subpectoral placement (p=0.012). For each 5-year age, ratio 1.44 (CI95% 1.04-2.01). every 50-cc volume, 1.28 1.02–1.55). Subpectoral carried an 11.5 1.7-77.3) compared prepectoral under autologous transfer (latissimus free transfer). Conclusion institution within ranges previously published. quarter able successfully avoid prompt initiation antibiotic therapy. history noted be significant developing expanders. Explantation more common increases volumes. Surprisingly, portended significantly higher as placed flap. BMI, smoking, intent (prophylactic vs curative), adjuvant radiation, acellular dermal matrix not