TY - JOUR
T1 - Strategy for salvaging infected breast implants
T2 - Lessons from the recovery of seven consecutive patients
AU - Yeo, Hyeonjung
AU - Lee, Dongkyu
AU - Kim, Jin Soo
AU - Eo, Pil Seon
AU - Kim, Dong Kyu
AU - Lee, Joon Seok
AU - Kwon, Ki Tae
AU - Lee, Jeeyeon
AU - Park, Ho Yong
AU - Yang, Jung Dug
N1 - Publisher Copyright:
© 2021 The Korean Society of Plastic and Reconstructive Surgeons.
PY - 2021/3
Y1 - 2021/3
N2 - Background In recent years, implant-based breast reconstruction has been performed be-cause of its simplicity, short operation time, and rapid recovery of patients. Several studies have reported treatment methods for implant surgery-related infection, which is a serious complication. The aim of this study was to introduce our strategy for salvaging infected implants and to evaluate its effectiveness. Methods The authors performed a retrospective study of 145 cases from 132 patients who underwent implant-based breast reconstruction from January 2012 to December 2018. Empirical antibiotics were immediately administered to patients with suspected infections. The patients then underwent salvage treatment including appropriate antibiotics, ultrasonogra-phy-guided aspiration, debridement, antibiotic lavage, and implant exchange through a mul-tidisciplinary approach. Patient demographics, operative data, duration until drain removal, adjuvant treatment, and complications were analyzed. Results The total infection rate was 5.5% (8/145). A longer indwelling catheter period and adjuvant treatment were significantly associated with infection. The salvage treatment showed a success rate of 87.5% (7/8). Seven patients who received early aggressive salvage treatment recovered from infection. One patient with methicillin-resistant Staphylococcus aureus, who received salvage treatment 11 days after symptom onset, did not respond to drainage and antibiotic treatment. That patient subsequently underwent explantation. Conclusions In implant-based breast reconstruction, prevention of infection is of the utmost importance. However, if an infection is suspected, proactive empirical antibiotic therapy and collaboration with the necessary departments are required. Through a multidisciplinary approach and proactive early management, swift and appropriate salvage should be performed.
AB - Background In recent years, implant-based breast reconstruction has been performed be-cause of its simplicity, short operation time, and rapid recovery of patients. Several studies have reported treatment methods for implant surgery-related infection, which is a serious complication. The aim of this study was to introduce our strategy for salvaging infected implants and to evaluate its effectiveness. Methods The authors performed a retrospective study of 145 cases from 132 patients who underwent implant-based breast reconstruction from January 2012 to December 2018. Empirical antibiotics were immediately administered to patients with suspected infections. The patients then underwent salvage treatment including appropriate antibiotics, ultrasonogra-phy-guided aspiration, debridement, antibiotic lavage, and implant exchange through a mul-tidisciplinary approach. Patient demographics, operative data, duration until drain removal, adjuvant treatment, and complications were analyzed. Results The total infection rate was 5.5% (8/145). A longer indwelling catheter period and adjuvant treatment were significantly associated with infection. The salvage treatment showed a success rate of 87.5% (7/8). Seven patients who received early aggressive salvage treatment recovered from infection. One patient with methicillin-resistant Staphylococcus aureus, who received salvage treatment 11 days after symptom onset, did not respond to drainage and antibiotic treatment. That patient subsequently underwent explantation. Conclusions In implant-based breast reconstruction, prevention of infection is of the utmost importance. However, if an infection is suspected, proactive empirical antibiotic therapy and collaboration with the necessary departments are required. Through a multidisciplinary approach and proactive early management, swift and appropriate salvage should be performed.
KW - Breast implants
KW - Infections
KW - Interdisciplinary studies
KW - Mammaplasty
KW - Salvage therapy
UR - http://www.scopus.com/inward/record.url?scp=85103507429&partnerID=8YFLogxK
U2 - 10.5999/aps.2020.01578
DO - 10.5999/aps.2020.01578
M3 - Article
AN - SCOPUS:85103507429
SN - 2234-6163
VL - 48
SP - 165
EP - 174
JO - Archives of Plastic Surgery
JF - Archives of Plastic Surgery
IS - 2
ER -