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Related Concept Videos

Factors Affecting the Risk of Infection01:26

Factors Affecting the Risk of Infection

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The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
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Related Experiment Video

Updated: Sep 30, 2025

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
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Infections after mastectomy and tissue expander placement: A multivariate regression analysis.

Franca Kraenzlin1, Mehran Habibi1, Oluseyi Aliu1

  • 1Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, 601 North Caroline Street, Baltimore, MD 21287, United States.

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
|March 13, 2022
PubMed
Summary

Infections after tissue expander-based breast reconstruction (TE-BR) are linked to increased patient age, drain retention, seromas, and necrosis. Longer antibiotic use did not prevent these infections.

Keywords:
Breast reconstructionInfections after breast reconstructionTissue expander-based breast reconstruction

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Area of Science:

  • Plastic Surgery
  • Surgical Site Infections
  • Breast Reconstruction

Background:

  • Tissue expander-based breast reconstruction (TE-BR) has significantly higher infection rates (up to 31%) compared to standard breast surgery.
  • Identifying risk factors for TE-BR infections is crucial for improving patient outcomes.

Purpose of the Study:

  • To analyze risk factors contributing to infections following tissue expander placement during breast reconstruction.
  • To evaluate the impact of drain retention duration and post-operative antibiotic use on infection rates.

Main Methods:

  • A retrospective study analyzed 311 patients undergoing mastectomy with tissue expander (TE) placement over 22 months.
  • Infections were defined by clinical documentation, return to operating room, or positive cultures.
  • Multivariate logistic regression identified significant risk factors for infection.

Main Results:

  • 13.5% of breasts developed infection before the second stage reconstruction.
  • Infection risk increased with patient age (OR 1.04), full-thickness necrosis (OR 6.64), seromas requiring drainage (OR 2.79), and longer drain therapy (OR 1.04).
  • Extended post-operative antibiotic duration did not reduce infection rates.

Conclusions:

  • Key risk factors for TE-BR infections include advanced patient age, prolonged drain use, seromas, and tissue necrosis.
  • Current antibiotic protocols may not be sufficient to prevent infections in TE-BR.
  • Further prospective research is needed to optimize antibiotic strategies and reduce morbidity in TE-BR patients.