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Open Access
CC BY-NC 4.0 · Arch Plast Surg 2021; 48(02): 165-174
DOI: 10.5999/aps.2020.01578
Breast/Trunk
Original Article

Strategy for salvaging infected breast implants: lessons from the recovery of seven consecutive patients

Authors

  • Hyeonjung Yeo 

    Department of Plastic and Reconstructive Surgery, Daegu Fatima Hospital, Daegu, Korea

  • Dongkyu Lee 

    Department of Plastic and Reconstructive Surgery, Daegu Fatima Hospital, Daegu, Korea

  • Jin Soo Kim 

    Department of Plastic and Reconstructive Surgery, Kyungpook National University, Daegu, Korea

  • Pil Seon Eo 

    Department of Plastic and Reconstructive Surgery, Kyungpook National University, Daegu, Korea

  • Dong Kyu Kim 

    Department of Plastic and Reconstructive Surgery, Kyungpook National University, Daegu, Korea

  • Joon Seok Lee 

    Department of Plastic and Reconstructive Surgery, Kyungpook National University, Daegu, Korea

  • Ki Tae Kwon 

    Division of Infectious Diseases, Department of Internal Medicine, Kyungpook National University, Daegu, Korea

  • Jeeyeon Lee 

    Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Korea

  • Ho Yong Park 

    Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Korea

  • Jung Dug Yang 

    Department of Plastic and Reconstructive Surgery, Kyungpook National University, Daegu, Korea

This article was presented at the Global Breast Cancer Conference 2019 (GBCC 2019) on April 25–27, in Incheon, Korea.
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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.

Keywords

Mammaplasty - Breast implants - Infections - Salvage therapy - Interdisciplinary studies


Publication History

Received: 10 August 2020

Accepted: 13 December 2020

Article published online:
07 March 2022

© 2021. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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