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KMID : 1038220210480020165
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Archives of Plastic Surgery
2021 Volume.48 No. 2 p.165 ~ p.174
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Strategy for salvaging infected breast implants: lessons from the recovery of seven consecutive patients
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Yeo Hyeon-Jung
Lee Dong-Kyu
Kim Jin-Soo
Eo Pil-Seon
Kim Dong-Kyu
Lee Joon-Seok
Kwon Ki-Tae
Lee Jee-Yeon
Park Ho-Yong
Yang Jung-Dug
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Abstract
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Background: In recent years, implant-based breast reconstruction has been performed because of its simplicity, short operation time, and rapid recovery of patients. Several studies have reported treatment methods for implant surgery-related infection, which is a serious complication. The aim of this study was to introduce our strategy for salvaging infected implants and to evaluate its effectiveness.
Methods: The authors performed a retrospective study of 145 cases from 132 patients who underwent implant-based breast reconstruction from January 2012 to December 2018. Empirical antibiotics were immediately administered to patients with suspected infections. The patients then underwent salvage treatment including appropriate antibiotics, ultrasonography-guided aspiration, debridement, antibiotic lavage, and implant exchange through a multidisciplinary approach. Patient demographics, operative data, duration until drain removal, adjuvant treatment, and complications were analyzed.
Results: The total infection rate was 5.5% (8/145). A longer indwelling catheter period and adjuvant treatment were significantly associated with infection. The salvage treatment showed a success rate of 87.5% (7/8). Seven patients who received early aggressive salvage treatment recovered from infection. One patient with methicillin-resistant Staphylococcus aureus, who received salvage treatment 11 days after symptom onset, did not respond to drainage and antibiotic treatment. That patient subsequently underwent explantation.
Conclusions: In implant-based breast reconstruction, prevention of infection is of the utmost importance. However, if an infection is suspected, proactive empirical antibiotic therapy and collaboration with the necessary departments are required. Through a multidisciplinary approach and proactive early management, swift and appropriate salvage should be performed.
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KEYWORD
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Mammaplasty, Breast implants, Infections, Salvage therapy, Interdisciplinary studies
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