Close the GAPS: A Standardized Perioperative Protocol Reduces Breast Reconstruction Implant Infections

Area of Science:

• Plastic Surgery
• Surgical Outcomes
• Infection Control

Background:

• Implant-based breast reconstruction (IBBR) is complex with variable practices.
• Postoperative infections in IBBR increase readmission, reoperation, and failure rates.
• A standardized protocol was implemented to reduce variability and infections.

Purpose of the Study:

• To evaluate the effectiveness of a standardized perioperative protocol for IBBR.
• To reduce process variability and postoperative infection rates.
• To decrease reconstructive failure secondary to infection.

Main Methods:

• A single institution applied a standardized IBBR protocol from Dec 2019 to Feb 2021.
• Intraoperative protocol adherence was recorded; infections were categorized as minor or major.
• A retrospective analysis of a historic control group was performed for comparison.

Main Results:

• The protocol group (69 patients) showed a significantly lower overall infection rate (8.7% vs. 17.0%) compared to controls (159 patients).
• Reconstructive failure due to infection was significantly reduced in the protocol group (4.4% vs. 8.8%).
• Higher protocol adherence correlated with lower infection rates among protocol patients (81.5% vs. 72.2%).

Conclusions:

• A standardized perioperative protocol for IBBR effectively reduces process variability.
• The protocol significantly decreases the overall infection rate and reconstructive failure secondary to infection.
• Standardization of IBBR protocols improves patient safety and reconstructive success.