BACKGROUND: Breast prosthesis reconstruction continues to be the most common form of breast reconstruction, and infection and exposure remain major concerns for patients and surgeons. METHODS: A retrospective review was performed of patients who underwent attempted implant salvage between 2002 and 2008 by a single surgeon according to a single protocol. Analyzed data include detailed patient demographics, clinical and laboratory findings, and outcomes. RESULTS: Sixty patients were identified who had been taken to the operating room secondary to infection and/or exposure of a breast prosthesis. Seventeen underwent removal of the prosthesis without attempted salvage and 43 patients underwent attempted salvage. Successful attempted salvage occurred in 76.7 percent of cases, with a mean follow-up of 18.4 months (range, 1 to 60 months). Staphylococcus epidermidis led to a statistically higher rate of failed salvage (25 percent versus 0 percent, p = 0.04). Of the 33 patients who had successful salvage of the prosthesis, two developed capsular contracture (6 percent). CONCLUSIONS: Intervention should be prompt and aggressive, and should implement a combination of surgical and antimicrobial therapies. The data from the authors' results provide additional tools for patient selection and treatment, and offer a simplified management protocol for breast reconstruction patients with infected and/or exposed breast prostheses. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
BACKGROUND: Breast prosthesis reconstruction continues to be the most common form of breast reconstruction, and infection and exposure remain major concerns for patients and surgeons. METHODS: A retrospective review was performed of patients who underwent attempted implant salvage between 2002 and 2008 by a single surgeon according to a single protocol. Analyzed data include detailed patient demographics, clinical and laboratory findings, and outcomes. RESULTS: Sixty patients were identified who had been taken to the operating room secondary to infection and/or exposure of a breast prosthesis. Seventeen underwent removal of the prosthesis without attempted salvage and 43 patients underwent attempted salvage. Successful attempted salvage occurred in 76.7 percent of cases, with a mean follow-up of 18.4 months (range, 1 to 60 months). Staphylococcus epidermidis led to a statistically higher rate of failed salvage (25 percent versus 0 percent, p = 0.04). Of the 33 patients who had successful salvage of the prosthesis, two developed capsular contracture (6 percent). CONCLUSIONS: Intervention should be prompt and aggressive, and should implement a combination of surgical and antimicrobial therapies. The data from the authors' results provide additional tools for patient selection and treatment, and offer a simplified management protocol for breast reconstruction patients with infected and/or exposed breast prostheses. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
Authors: Amy S Xue; Katarzyna E Kania; Rodger H Brown; Jamal M Bullocks; Larry H Hollier; Shayan A Izaddoost Journal: Semin Plast Surg Date: 2016-05 Impact factor: 2.314
Authors: Farid Meybodi; Negin Sedaghat; Elisabeth Elder; James French; Kristian Adams; Jeremy Hsu; Kavitha Kanesalingam; Meagan Brennan Journal: Plast Reconstr Surg Glob Open Date: 2021-03-26
Authors: Elisa Antoniazzi; Riccardo Villani; Erich Fabbri; Veronica Vietti Michelina; Giorgio D'Angelo; Valeria Summo; Riccardo Cipriani; Paolo Giovanni Morselli; Daniele Fasano Journal: Plast Reconstr Surg Glob Open Date: 2016-03-18
Authors: Eduardo Montag; Alberto Okada; Eduardo G P Arruda; Alexandre M Munhoz; Fabio F Busnardo; Rolf Gemperli Journal: Int J Surg Case Rep Date: 2019-09-13