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Related Experiment Video

Updated: Jun 9, 2025

Quantification of Strain in a Porcine Model of Skin Expansion Using Multi-View Stereo and Isogeometric Kinematics

Quantification of Strain in a Porcine Model of Skin Expansion Using Multi-View Stereo and Isogeometric Kinematics

Published on: April 16, 2017

Management of the Infected Tissue Expander.

Jonas A Nelson¹, Perri S Vingan¹, Francis D Graziano¹

¹From the Plastic and Reconstructive Surgery Service, Department of Surgery.

Plastic and Reconstructive Surgery

|October 25, 2024

Summary

Tissue expander infection after breast reconstruction is common. Prompt antibiotics and surgery improve salvage rates, with implant replacement offering the best outcomes.

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Area of Science:

Plastic Surgery
Breast Reconstruction
Surgical Complications

Background:

Tissue expander infection is a significant complication in two-stage implant-based breast reconstruction.
Identifying risk factors and salvage rates is crucial for improving patient outcomes.

Purpose of the Study:

To assess risk factors for tissue expander infection and reconstructive loss.
To examine reconstructive salvage rates following infection.

Main Methods:

Retrospective review of 305 patients with tissue expander infection undergoing two-stage implant-based breast reconstruction (2017-2022).
Analysis included patients treated with antibiotics, interventional radiology drainage, and/or operative management.
Reconstructive success defined as maintenance of reconstruction for 1 year post-tissue expander placement.

Main Results:

Higher BMI, hypertension, radiation, bilateral expanders, acellular dermal matrix, increased mastectomy weight, and nipple-sparing mastectomy were linked to higher infection risk.
Patients with tissue expander infection had a 54% 1-year reconstructive failure rate.
Black race and Gram-negative cultures increased the hazard of reconstructive failure; implant replacement showed the best success rate.

Conclusions:

Overall, 46% of patients with periprosthetic infection achieved successful salvage.
Intravenous antibiotics and early operative intervention are recommended for tissue expander infections.
Practice is shifting from interventional radiology drainage to definitive operative management for periprosthetic infections.