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Related Experiment Video

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Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
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Absorbable antibiotic bead prophylaxis for implant-based breast reconstruction.

Casey Zhang1, Hilary Liu1, Shirley X Liu1

  • 1Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
|December 23, 2025
PubMed
Summary
This summary is machine-generated.

Prophylactic antibiotic beads may reduce infections in high-risk patients undergoing implant-based breast reconstruction (IBR). These beads also showed promise in salvage procedures for existing infections.

Keywords:
Antibiotic beadsAntibiotic prophylaxisBreast implant infectionBreast reconstructionImplant-based breast reconstructionProphylactic antibiotic beads

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Area of Science:

  • Plastic Surgery
  • Infectious Disease
  • Biomaterials

Background:

  • Periprosthetic infection is a significant complication following implant-based breast reconstruction (IBR).
  • Local antibiotic delivery via biodegradable beads is explored to mitigate infection risk.
  • This study evaluates preliminary experience with absorbable antibiotic beads in IBR.

Purpose of the Study:

  • To assess the efficacy of prophylactic antibiotic beads in reducing periprosthetic infections in high-risk IBR patients.
  • To evaluate the utility of antibiotic beads in salvage procedures for established periprosthetic infections.

Main Methods:

  • Retrospective cohort study of 287 patients undergoing IBR (January 2021 - October 2023).
  • High-risk patients (BMI >30, smoking, diabetes, radiation history) received antibiotic beads with standard care.
  • Outcomes analyzed: periprosthetic infection, re-operation for infection, wound complications; multivariate logistic regression used.

Main Results:

  • 27 patients received antibiotic beads, 260 received standard care.
  • No significant difference in infection requiring re-operation (11.1% vs. 16.5%) or explantation (7.4% vs. 10.8%) between groups.
  • Elevated BMI significantly associated with increased infection odds (OR 1.1).
  • Antibiotic beads achieved an 86.7% success rate in 15 salvage procedures for infection.

Conclusions:

  • Prophylactic antibiotic beads show potential for reducing infections in high-risk IBR patients.
  • Antibiotic beads demonstrate utility in implant salvage for periprosthetic infections.
  • Further prospective studies are necessary to confirm safety and efficacy.