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Infections following Immediate Implant-Based Breast Reconstruction: A Case-Control Study over 11 Years.

Joseph Banuelos1, M Diya Sabbagh1, Si-Gyun Roh1

  • 1From the Division of Plastic Surgery, the Division of Breast, Endocrine, Metabolic, and Gastrointestinal Surgery, Department of Surgery, the Division of Biomedical Statistics and Informatics, and the Division of Infectious Diseases, Department of Medicine, Mayo Clinic; Plastic Surgery Consultants; Jacobson Plastic Surgery; and Department of Plastic and Reconstructive Surgery, Jeonbuk National University Hospital.

Plastic and Reconstructive Surgery
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Summary
This summary is machine-generated.

Obesity, hypertension, and neoadjuvant chemotherapy increase surgical-site infection risk in breast reconstruction. Postoperative seroma and wound complications also elevate infection risk, aiding patient counseling.

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Area of Science:

  • Plastic Surgery
  • Surgical Outcomes
  • Infectious Disease

Background:

  • Surgical-site infection (SSI) following implant-based breast reconstruction negatively impacts outcomes and increases healthcare costs.
  • Identifying specific risk factors for SSI in immediate tissue expander/implant-based breast reconstruction is crucial for improving patient care.

Purpose of the Study:

  • To examine risk factors associated with surgical-site infection (SSI) after immediate tissue expander/implant-based breast reconstruction.
  • To identify patient demographics, comorbidities, and surgical variables that predict SSI in this population.

Main Methods:

  • Retrospective case-control study of patients undergoing immediate tissue expander/implant-based breast reconstruction between 2006 and 2016.
  • Inclusion criteria for SSI: infections requiring hospital admission, intravenous antibiotics, or surgical intervention, defined by CDC criteria.
  • Multivariable conditional logistic regression analysis was used to identify independent risk factors for SSI.

Main Results:

  • Higher body mass index (BMI), hypertension, and neoadjuvant chemotherapy were significantly associated with increased SSI risk.
  • Axillary lymph node dissection, postoperative seroma formation, and wound healing complications were also identified as major risk factors for SSI.
  • The study analyzed 270 breasts in 252 patients, with specific odds ratios (OR) and p-values highlighting the significance of these factors.

Conclusions:

  • Obesity, hypertension, and neoadjuvant chemotherapy are significant risk factors for SSI in immediate implant-based breast reconstruction.
  • Postoperative complications such as seroma and wound healing issues further increase the likelihood of SSI.
  • Findings can inform patient selection, counseling, and risk-factor-adjusted management strategies to mitigate SSI complications.