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Salvage of Infected Breast Implants
Joon Ho Song1, Young Seok Kim1, Bok Ki Jung1
1Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Gangnam Severance Hospital, Seoul, Korea.
Archives of Plastic Surgery
|October 28, 2017
Summary
Preventing infection is key in breast reconstruction. While many infections can be treated, early implant removal may not always be necessary, especially with a high salvage rate.
Area of Science:
- Plastic Surgery
- Breast Reconstruction
- Infectious Disease
Background:
- Implant-based breast reconstruction is increasingly common.
- Implants carry an elevated risk of infection.
- Understanding infection risk factors and salvage outcomes is crucial.
Purpose of the Study:
- To review clinical features of breast implant infections.
- To identify risk factors for breast device salvage failure.
Main Methods:
- Retrospective analysis of 771 patients undergoing implant-based breast reconstruction (2010-2016).
- Assessed risk factors: age, BMI, chemotherapy, radiation, smoking.
- Evaluated infection onset, pathogens, complications, mastectomy type, acellular dermal matrix use, comorbidities, and axillary node dissection.
Main Results:
- Overall infection rate: 4.99%; salvage rate: 58.6%.
- Staphylococcus aureus was the most common pathogen, with 37.5% methicillin resistance.
- Explantation was more frequent in 2-stage expander/implant reconstructions compared to direct-to-implant.
Conclusions:
- Infection prevention is paramount in breast reconstruction.
- High salvage rates suggest avoiding early implant removal.
- Consider implant removal for methicillin-resistant S. aureus infections unresponsive to treatment.
