Bacitracin for Injection Recall: Impact on Immediate Breast Implant Surgical Outcomes

Area of Science:

• Plastic Surgery
• Infectious Disease Prevention
• Surgical Outcomes

Background:

• Triple-antibiotic irrigation is standard for preventing infections in breast implant surgeries.
• Bacitracin, a common irrigation component, was recalled in January 2020 due to safety concerns.
• This recall prompted an investigation into its impact on postoperative complications.

Purpose of the Study:

• To evaluate the effect of bacitracin recall on infection rates in implant-based breast surgeries.
• To compare postoperative outcomes before and after the bacitracin recall.

Main Methods:

• A retrospective review of implant-based breast reconstruction and augmentation surgeries from January 2019 to February 2021.
• Utilizing a regression discontinuity design to compare pre- and post-bacitracin recall cohorts.
• Collecting and analyzing patient demographics, surgical details, and infection rates.

Main Results:

• 254 implants in 143 patients were analyzed; 172 before recall and 82 after.
• No significant difference in infection rates (6.4% vs. 8.5%) or cellulitis (3.5% vs. 3.7%) was observed between the pre- and post-recall groups.
• Implant infection was associated with smoking history and increased surgical time.

Conclusions:

• The recall of bacitracin from irrigation solutions did not negatively affect immediate complication rates in breast implant surgeries.
• Alternative antibiotic combinations for irrigation should be explored to maintain efficacy and improve long-term surgical benefits.
• Optimizing antibiotic irrigation protocols is crucial given bacitracin's unavailability.