Povidone-iodine Does Not Affect Acellular Dermal Matrix Integration in Patients Undergoing 2-staged, Prepectoral,...

Area of Science:

• Plastic Surgery
• Biomaterials Science
• Antimicrobial Agents

Background:

• Povidone-iodine was historically used for breast implant procedures but banned from 2000-2017.
• During the ban, acellular dermal matrix (ADM) was introduced; povidone-iodine's potential to harm fibroblasts and collagen synthesis raised concerns about ADM integration.
• The impact of povidone-iodine on ADM integration in breast reconstruction remained unknown.

Purpose of the Study:

• To investigate the effect of povidone-iodine on acellular dermal matrix (ADM) integration in breast reconstruction.
• To compare clinical outcomes and ADM integration rates between patients treated with povidone-iodine and those treated with triple-antibiotic solution.

Main Methods:

• Retrospective study of patients undergoing immediate, prepectoral, 2-staged breast reconstruction.
• Patients were divided into groups based on perioperative antimicrobial agent: povidone-iodine or triple-antibiotic solution for pocket irrigation and ADM/prosthesis presoaking.
• ADM integration (>25% vascularization) and postoperative complications were assessed at implant exchange.

Main Results:

• ADM integration occurred in 97% of breasts in both the povidone-iodine and triple-antibiotic groups.
• No significant differences in postoperative complications (infections, seroma, expander loss) were observed between the groups.
• Integrated ADMs appeared healthy with no foreign body reaction or significant bleeding issues.

Conclusions:

• Perioperative use of povidone-iodine for breast pocket irrigation and ADM/prosthesis presoaking does not adversely affect clinical outcomes in breast reconstruction.
• Povidone-iodine does not impede acellular dermal matrix integration, supporting its continued use in specific surgical contexts.