Thursday, February 16, 2012

BREAST SALVAGE AFTER RECONSTRUCTION

From time to time, as a Fort Myers plastic surgeon, I am exposed to journal articles and reports that may be a little technical for the average reader. But I like to include them here because they may be of interest to some people.

One of the most dreaded complications after breast reconstruction is to develop an infection. A recent study was reported in the Plastic Surgery Journal. It chronicled one surgeons experience.

Once an infection is established, ie: fever, swelling, erythemia or redness, then one must act right away. Usually broad spectrum antibiotics are started. The patient is then taken to the operation room and the infected prosthesis is removed, cultures taken and the pocket is debrided and irrigated with normal saline and antibacterial solution.

If the pocket, in the opinion of the surgeon, was not overly infected, a new prosthesis was placed along with a suction drain. The drain was removed when the output was less than 30 cc’s within 24 hours.

If in the surgeon's opinion, the infection was judged too severe, the prosthesis was NOT replaced.

In the surgeons surveys gathered over several years (2002-2008), 60 patients were identified. Of these, 17 patients (28%) did NOT have the prosthesis replaced. A total of 33 patients had a successful salvage procedure. The success rate was about 77%.

Also of interest was the fact that the average time between the actual reconstruction and the infection / implant exposure was about 14 months.

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