Salvage of Infected Breast Implants
نویسندگان
چکیده
BACKGROUND Implant-based breast reconstruction is being performed more frequently, and implants are associated with an increased risk of infection. We reviewed the clinical features of cases of implant infection and investigated the risk factors for breast device salvage failure. METHODS We retrospectively analyzed 771 patients who underwent implant-based breast reconstruction between January 2010 and December 2016. Age, body mass index, chemotherapy history, radiation exposure, and smoking history were assessed as potential risk factors for postoperative infection. We also evaluated the presence and onset of infection symptoms, wound culture pathogens, and other complications, including seroma, hematoma, and mastectomy skin necrosis. Additionally, we examined the mastectomy type, the use of acellular dermal matrix, the presence of an underlying disease such as hypertension or diabetes, and axillary node dissection. RESULTS The total infection rate was 4.99% (58 of 1,163 cases) and the total salvage rate was 58.6% (34 of 58). The postoperative duration to closed suction drain removal was significantly different between the cellulitis and implant removal groups. Staphylococcus aureus infection was most frequently found, with methicillin resistance in 37.5% of the cases of explantation. Explantation after infection was performed more often in patients who had undergone 2-stage expander/implant reconstruction than in those who had undergone direct-to-implant reconstruction. CONCLUSIONS Preventing infection is essential in implant-based breast reconstruction. The high salvage rate argues against early implant removal. However, when infection is due to methicillin-resistant S. aureus and the patient's clinical symptoms do not improve, surgeons should consider implant removal.
منابع مشابه
The infected breast prosthesis after mastectomy reconstruction: successful salvage of nine implants in eight consecutive patients.
BACKGROUND The use of tissue expanders and permanent implants has an established role in breast reconstruction after mastectomy. Periprosthetic infection, however, represents a known complication. The most conservative approach to severe or recalcitrant prosthetic infection remains removal of the device. However, removal makes subsequent reinsertion and reexpansion more difficult, with less pre...
متن کاملSalvage of Exposed Breast Implant Using Capsular Flaps
OBJECTIVE Extrusion represents potential complications associated with the use of breast implants. Attempts to salvage the exposed implants are rarely successful when poor tissue coverage or radiotherpy is present and therefore removal of implant and wound healing are mandatory. In these refractory complicated cases the use of capsular flaps can represent a useful tool to save the implant and a...
متن کاملSubacute Arterial Bleeding After Simultaneous Mastopexy and Breast Augmentation with Implants
Breast augmentation with implants is one of the most commonly performed plastic surgery procedures. The goal of the operation is to increase the size, shape or fullness of the breast. It is accomplished by placing silicone, saline or alternative composite breast implants under the chest muscles, fascia or the mammary gland. This type of operation is no exception concerning the occurrence of com...
متن کاملThe infected or exposed breast implant: management and treatment strategies.
Among the potential complications associated with the use of breast implants are the risks of periprosthetic infection and device extrusion. There is little published information about the effective management of these situations. Conservative recommendations include antibiotic therapy and removal of the implant until resolution of the infection or until the wound has healed. A retrospective re...
متن کامل