Infections in breast implants: a review with a focus on developing countries.

Area of Science:

• Infectious Diseases
• Surgical Infections
• Microbiology

Background:

• Surgical site infection (SSI) is an inherent risk in surgical procedures.
• The use of prosthetic materials, such as breast implants, is associated with a higher possibility of infection.
• Implant infection is a primary complication in breast aesthetic and reconstructive surgery, particularly in developing countries.

Purpose of the Study:

• To review current microbiological knowledge on breast implant infections.
• To focus on risk factors, diagnosis, clinical management, and antibiotic prophylaxis for implant infections in developing countries.

Main Methods:

• Literature review of microbiological knowledge regarding breast implant infections.
• Analysis of risk factors, diagnostic methods, and treatment strategies.
• Focus on data and reports from developing countries.

Main Results:

• Surgical site infection rates after breast augmentation range up to 2.9% (1.7% acute, 0.8% late).
• Surgical site infection rates after post-mastectomy breast reconstruction are higher, varying from 1% to 53%.
• Bacterial culture with antibiogram is the gold standard for diagnosis and antibiotic resistance identification.

Conclusions:

• Strict asepsis, preoperative antibiotic prophylaxis, and antibiotic irrigation are crucial for reducing infection risk.
• Empiric therapy with vancomycin and broad-spectrum penicillins/cephalosporins is recommended pending culture results.
• Some cases necessitate infected prosthesis removal; management requires careful consideration of diagnosis and resistance patterns.