Implant infections after breast reconstruction surgery following mastectomy: Experience from a Greek breast unit

Article type: Research Article

Authors: Michalopoulos, Nikolaos V.^{a; b} | Frountzas, Maximos^a; | Karathanasis, Panagiotis^a | Theodoropoulos, Charalampos^a | Kolia, Aikaterini^a | Zografos, Constantinos G.^a | Triantafyllou, Tania^a | Larentzakis, Andreas^a | Danias, Nikolaos^b | Zografos, George C.^a

Affiliations: [a] 1st Department of Propaedeutic Surgery, Medical School, University of Athens, “Hippocratio” General Hospital, Athens, Greece | [b] 4th Department of Surgery, Medical School, University of Athens, “Attikon” University Hospital, Chaidari, Greece

Correspondence: [*] Corresponding author: Maximos Frountzas, MD, “Hippocratio” General Hospital, 114 Vas. Sophias Av., 11527 Athens, Greece. Tel.: +0030 697 88 80 045; Fax: +0030 210 77 07 574. E-mail: [email protected]; ORCID: https://orcid.org/0000-0001-9157-9860

Abstract: BACKGROUND:Despite the dominance of implant-based breast reconstruction after mastectomy, during recent years, it has been correlated to some complications. The aim of this study is to present the Greek experience about management of implant infections after breast reconstructions and to investigate the relationship between possible risk factors and breast pocket fluid cultures. METHODS:In total, 260 patients underwent implant-based breast reconstruction due to breast cancer in our center from 2016 until 2020. 46 patients, that underwent implant or expander replacement after breast reconstruction due to mastectomy were included in the present study. RESULTS:260 patients underwent breast reconstruction in our center and in 46 (18%) of them an implant replacement was required. 21 patients (8%) presented clinically with an implant infection, but 12 of them (5%) had positive cultures from the breast pocket fluid. On the contrary, 25 patients (10%) presented no clinical signs of implant infection, but 5 of them (2%) had a positive culture. In addition, we demonstrated a correlation between implant infection and positive cultures (p = 0.009), along with an association between chemotherapy before implant placements and negative cultures (p = 0.035). Finally, the most common pathogen was Staphylococcus epidermidis (29%), followed by Escherichia coli (24%) and Staphylococcus aureus (18%). CONCLUSION:Implant infection still remains a very serious complication after breast reconstruction surgery. The establishment of a therapeutic protocol, with specific antimicrobial and surgical targets seems as an effective strategy against implant infections.

Keywords: Implant, infection, breast, cancer, reconstruction

DOI: 10.3233/BD-201077

Journal: Breast Disease, vol. 41, no. 1, pp. 37-44, 2022