Infectious complications following breast reconstruction with expanders and implants

Area of Science:

• Plastic Surgery
• Oncology
• Infectious Disease

Background:

• Infection incidence after breast reconstruction with expanders and implants varies widely (1-24%).
• Previous studies identified potential infection factors but lacked comprehensive multifactorial analysis.

Purpose of the Study:

• To analyze multiple factors predisposing women to expander or implant infection following breast reconstruction.
• To determine the statistical significance of various clinical and treatment-related factors on infection rates.

Main Methods:

• Retrospective analysis of 168 implant reconstructions in 130 women (1997-2000).
• Factors analyzed included axillary lymph node dissection, chemotherapy, radiation therapy, tumor stage, implant timing, laterality, tobacco use, and diabetes.
• Stepwise logistic regression was used for statistical analysis.

Main Results:

• Infectious complications occurred in 7.7% of women and 5.9% of implants.
• Radiation therapy showed a significant association (p < 0.04) with implant infection (4.88 times higher risk).
• Lymph node dissection showed suggestive evidence (p < 0.09) of increased infection risk (6.29 times higher).

Conclusions:

• Radiation therapy is a significant risk factor for infection in breast implant reconstruction.
• Axillary lymph node dissection may also increase infection risk, warranting careful consideration.
• Age, diabetes, chemotherapy, tumor stage, implant timing, and tobacco use were not significantly associated with infection in this cohort.