STUDY: The infected breast prosthesis after mastectomy reconstruction: successful salvage of nine implants in eight consecutive patients.

Note from Ilena Rosenthal:
Earlier studies revealed that up to one third of post mastectomy
implant recipients had to undergo additional surgeries for various
reasons during just the first 5 years.

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The infected breast prosthesis after mastectomy reconstruction:
successful salvage of nine implants in eight consecutive patients.Chun
JK, Schulman MR.

http://www.ncbi.nlm.nih.gov/sites/en...=pubmed_DocSum
Division of Plastic and Reconstructive Surgery, Mount Sinai Medical
Center, New York, NY 10029-6574, USA. jin.chun@mountsinai.org

BACKGROUND: The use of tissue expanders and permanent implants has an
established role in breast reconstruction after mastectomy.
Periprosthetic infection, however, represents a known complication.
The most conservative approach to severe or recalcitrant prosthetic
infection remains removal of the device. However, removal makes
subsequent reinsertion and reexpansion more difficult, with less
predictable cosmetic results. The authors believe that timely surgical
intervention directed toward salvage of infected breast prostheses can
be successful, without demonstrating increased capsular contracture.
METHODS: The authors present nine consecutive cases of infected breast
implants (nine implants in eight patients). All patients had
previously undergone mastectomy for malignancy and immediate
expander/implant reconstruction. Six patients had localized infections
that failed to respond to oral antibiotics and two women initially
presented with systemic infection. All patients were placed on
intravenous antibiotics followed by drainage of fluid, manual
debridement and curettage of the infected pocket, device exchange, and
postoperative antibiotics. RESULTS: All nine infected breast
prostheses responded to this approach and currently remain intact and
without recurrent infection. Mean time to follow-up for all patients
was 14.6 months (range, 10 to 25 months). CONCLUSIONS: In patients
with severely infected breast prostheses, timely operative
intervention can salvage the previously "unsalvageable" implant; in
addition, the surgically replaced implants did not develop severe
capsular contractures. Surgical salvage of severely infected breast
prostheses after mastectomy is a treatment option that should be
considered when dealing with severe or recalcitrant infection in a
suitable patient.