Postoperative Infection After Implant-Based Breast Reconstruction: Risk Factors and Clinical Burden in a Large...

Area of Science:

• Plastic Surgery
• Surgical Oncology
• Breast Reconstruction Techniques

Background:

• Implant-based breast reconstruction (IBBR) is a common post-mastectomy procedure.
• Postoperative infection is a significant complication of IBBR, leading to reoperation, implant removal, and reconstruction failure.
• Understanding infection incidence and risk factors is crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate the incidence, determinants, and clinical burden of infection following IBBR.
• To identify independent predictors associated with postoperative infection in a large cohort.

Main Methods:

• Retrospective observational study of 1537 reconstructed breasts undergoing IBBR.
• Infection defined clinically (erythema, pain, swelling, secretion requiring antibiotics).
• Multivariate binomial logistic regression analysis to assess independent predictors.

Main Results:

• The incidence of postoperative infection was 4.3% (66/1525 breasts).
• Longer operative time (OR 1.005 per minute) and prepectoral reconstruction (OR 2.31) were independently associated with increased infection risk.
• Infection accounted for 52.7% of explantations with available indication data.

Conclusions:

• Infection post-IBBR is a significant cause of morbidity, frequently necessitating further surgical intervention.
• Extended operative duration is the most consistent independent risk factor for infection.
• Prepectoral reconstruction shows an association with infection, requiring careful consideration of reconstructive context.