One-Step Salvage of Infected Prosthetic Breast Reconstructions Using Antibiotic-Impregnated Polymethylmethacrylate Plates and Concurrent Tissue Expander Exchange

Annals of Plastic Surgery
Steven B AlbrightShayan A Izaddoost

Abstract

Periprosthetic infection represents a major complication in breast reconstruction, frequently leading to expander-implant loss. Recent studies report variable success in the salvage of infected breast prostheses through systemic antibiotic therapy and surgical intervention. There is currently no consensus regarding a management algorithm for attempted salvage. The purpose of this pilot study was to evaluate the early outcomes of a protocol using antibiotic-impregnated polymethylmethacrylate (PMMA) implant placement with expander device exchange. A retrospective database was queried to identify all patients with infected implant-based breast reconstruction who were treated by the study authors and who underwent attempted salvage under the study protocol. All patients received intravenous antibiotics followed by surgical debridement of the infected pocket, insertion of antibiotic-impregnated PMMA plates and/or beads, device exchange, and postoperative antibiotics. After clinical resolution of infection, tissue expansion was performed with the PMMA implants remaining in situ until exchanged to permanent implants. All patients with infected prosthetic breast reconstructions achieved implant pocket sterilization using this method. A...Continue Reading

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Citations

Feb 15, 2017·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Varun V VaradarajanPatrick J Antonelli
Dec 15, 2017·Plastic and Reconstructive Surgery·Denise M KennaKendra Eveler
Jul 15, 2021·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Muholan KanapathyAfshin Mosahebi

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