Absorbable antibiotic bead prophylaxis for implant-based breast reconstruction.

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.