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• W2756638805 abstract "INTRODUCTION: Tissue expander(TE) and implant infection is the most common cause of surgical readmission following breast reconstruction. The goals of this study are (1) to characterize a cohort of patients who were treated with IV antibiotics for suspected infection after prosthetic breast reconstruction, (2) to identify local microbiome and (3) elucidate an optimal antibiotic treatment protocol (4) to identify risk factors for explantation. METHODS: A retrospective review of a prospectively maintained database was performed to identify prosthetic breast reconstruction patients who were diagnosed with a suspected infection and underwent IV antibiotic treatment. Patient characteristics, surgical details, outcomes of the suspected infection, accompanying complications, treatment modalities and culture data were reviewed. Comparisons were made between patients whose implants were salvaged versus explanted. RESULTS: Fifty-nine patients with 67 tissue expanders/implants underwent IV antibiotic treatment with suspected infection during a two-year period (2014–2016). Of the reconstructions, 44(66%) were tissue expanders and 23(34%) were implants. Mean follow-up was 14.3 months. The most common IV treatment protocol was a combination of Daptomycin and Zosyn. Cultures were obtained in 43 infectious episodes which revealed. S. epidermidis as the most commonly encountered pathogen followed by P. aeruginosa. A total of 34 devices (51%, 26 expanders and 8 implants) were explanted. Explantations were more common in patients with a history of chemotheraphy (p=0.02), hypertension (p=0.03) and those who underwent therapeutic mastectomy (p=0.03). A higher rate of explantation was observed among cases with coexisting complications, a history of radiation, and in patients with larger breasts, howerver this difference was not statistical significant. CONCLUSION: Chemotheraphy, hypertension and the therapeutic mastectomy were found to be independent risk factors for explantation due to postoperative infection following breast reconstruction. Prompt diagnosis of the implant infection with appropriate treatment, particularly in high risk patients is the key to avoid explantation. The combination therapy of Daptomycin and Zosyn has broad spectrum coverage and are found effective." @default.
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• W2756638805 date "2017-09-01" @default.
• W2756638805 modified "2023-09-24" @default.
• W2756638805 title "Abstract: Management of Breast Implant Associated Infections in Breast Reconstruction" @default.
• W2756638805 doi "https://doi.org/10.1097/01.gox.0000526240.26734.f6" @default.
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