Breast Tissue Expander—Related Infections: Perioperative Antimicrobial Regimens

Viola, George M.; Raad, Issam; Rolston, Kenneth V. I.

doi:10.1086/674390

Cited by 30 publications

(34 citation statements)

References 42 publications

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“…However, several recent studies indicate that a small but significant proportion of these infections are caused by Gram-negative bacilli such as E. coli , P. aeruginosa , and Klebsiella species [38–40]. Non-tuberculous mycobacterial and polymicrobial infections are less common but are difficult to manage [41]. With a significant rate of, and changing epidemiology of, infection in this setting, infection prevention has become extremely important.…”

Section: Specific Syndromes/sites Of Infectionmentioning

confidence: 99%

Infections in Cancer Patients with Solid Tumors: A Review

2017

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Solid tumors are much more common than hematologic malignancies. Although severe and prolonged neutropenia is uncommon, several factors increase the risk of infection in patients with solid tumors, and the presence of multiple risk factors in the same patient is not uncommon. These include obstruction (most often caused by progression of the tumor), disruption of natural anatomic barriers such as the skin and mucosal surfaces, and treatment-related factors such as chemotherapy, radiation, diagnostic and/or therapeutic surgical procedures, and the increasing use of medical devices such as various catheters, stents, and prostheses. Common sites of infection include the skin and skin structures (including surgical site infections), the bloodstream (including infections associated with central venous catheters), the lungs, the hepato-biliary and intestinal tracts, and the urinary tract, and include distinct clinical syndromes such as post-obstructive pneumonia, obstructive uropathy, and neutropenic enterocolitis. The epidemiology of most of these infections is changing with resistant organisms [MRSA, Pseudomonas aeruginosa, extended spectrum beta-lactamase (ESBL)-producing organisms] being isolated more often than in the past. Polymicrobial infections now predominate when deep tissue sites are involved. Conservative management of most of these infections (antibiotics, fluid and electrolyte replacement, bowel rest when needed) is generally effective, with surgical intervention being reserved for the drainage of deep abscesses, or to deal with complications such as intestinal obstruction or hemorrhage. Infected prostheses often need to be removed. Reactivation of certain viral infections (HBV, HCV, and occasionally CMV) has become an important issue, and screening, prevention and treatment strategies are being developed. Infection prevention, infection control, and antimicrobial stewardship are important strategies in the overall management of infections in patients with solid tumors. Occasionally, infections mimic solid tumors and cause diagnostic and therapeutic challenges.

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Section: Specific Syndromes/sites Of Infectionmentioning

confidence: 99%

Infections in Cancer Patients with Solid Tumors: A Review

2017

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“…Finally, in addition to the wide range of clinical presentations of breast implant infections, there is still debate on the best clinical management to achieve implant salvage with few randomized or controlled studies to identify best management practices [22].…”

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confidence: 99%

Clinical and Microbiological Characterization of Late Breast Implant Infections after Reconstructive Breast Cancer Surgery

Franchelli

Pesce

Savaia

et al. 2015

Surgical Infections

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“…S . epidermidis are the most common coagulase-negative staphylococci, and have been described as the bacteria most frequently involved in SSI after breast operations [8]. However, many other authors reported S .…”

Section: Discussionmentioning

confidence: 99%

Dressing Wear Time after Breast Reconstruction: A Randomized Clinical Trial

et al. 2016

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BackgroundThe evidence to support dressing standards for breast surgery wounds is empiric and scarce.ObjectiveThis two-arm randomized clinical trial was designed to assess the effect of dressing wear time on surgical site infection (SSI) rates, skin colonization and patient perceptions.MethodsA total of 200 breast cancer patients undergoing breast reconstruction were prospectively enrolled. Patients were randomly allocated to group I (dressing removed on the first postoperative day, n = 100) or group II (dressing removed on the sixth postoperative day, n = 100). SSIs were defined and classified according to criteria from the Centers for Disease Control and Prevention. Samples collected before placing the dressing and after 1 day (group I) and 6 days (both groups) were cultured for skin colonization assessments. Patients preferences and perceptions with regard to safety, comfort and convenience were recorded and analyzed.ResultsA total of 186 patients completed the follow-up. The global SSI rate was 4.5%. Six patients in group I and three in group II had SSI (p = 0.497). Before dressing, the groups were similar with regard to skin colonization. At the sixth day, there was a higher colonization by coagulase-negative staphylococci in group I (p<0.0001). Patients preferred to keep dressing for six days (p<0.0001), and considered this a safer choice (p<0.05).ConclusionsDespite group I had a higher skin colonization by coagulase-negative staphylococci on the sixth postoperative day, there was no difference in SSI rates. Patients preferred keeping dressing for six days and considered it a safer choice.Trial RegistrationClinicalTrials.gov NCT01148823

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Breast Tissue Expander—Related Infections: Perioperative Antimicrobial Regimens

Cited by 30 publications

References 42 publications

Infections in Cancer Patients with Solid Tumors: A Review

Infections in Cancer Patients with Solid Tumors: A Review

Clinical and Microbiological Characterization of Late Breast Implant Infections after Reconstructive Breast Cancer Surgery

Dressing Wear Time after Breast Reconstruction: A Randomized Clinical Trial

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