Dual-Port and Single-Port Tissue Expanders in Postmastectomy Breast Reconstruction: a retrospective cohort study

Chiang, Sarah N; Varagur, Kaamya; Ribaudo, Joseph G.; Skolnick, Gary B; Sacks, Justin M; Christensen, Joani M

doi:10.1016/j.bjps.2023.09.019

Cited by 1 publication

(1 citation statement)

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“…49 Conversely, a recent study by Chiang et al found an increase in infections in their dual-port patients; however, there was a significant decrease in the need to return to the operating room for management ( P = 0.01). 50 Similar to Chiang et al, our study noted an increase in overall infections in the dual-port patients, and we were also able to manage these with fewer returns to the operating room (a decrease in major infections) and overall less expander loss. The discrepancy of infection rates between articles is likely in the definition.…”

Section: Discussionsupporting

confidence: 86%

The Effect of Early Cultures and Dual-port Expanders on Two-stage, Prepectoral Breast Reconstruction: The 25/25 Study

Moyer,

Sisson

2024

Plastic and Reconstructive Surgery - Global Open

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Background: Two-stage tissue expander to implant surgery remains the predominant technique for breast reconstruction. Unfortunately, there is a high incidence of reconstruction failure which portends a financial and emotional burden. Most failures are related to postmastectomy skin flap necrosis and infection. Recently, a dual-port tissue expander was introduced to the market, and the authors hypothesize that early cultures from the peri-implant fluid will guide antibiotic treatment and decrease reconstruction failure. Methods: This is a cohort study of 50 consecutive patients treated for breast cancer or genetic susceptibility via a two-stage, prepectoral technique. The first 25 patients (46 breasts) were treated with a variety of tissue expanders, and the subsequent 25 patients (47 breasts) received a dual-port expander. Routine cultures from the drain port were taken from the dual-port group at the second postoperative visit, and cultures were taken in the control group only when signs of infection were present. All other procedures and interventions were similar. Results: Fifty patients, totaling 93 breasts, completed the study with a mean follow-up of 145 days. There were no statistically significant demographic or pathologic differences between groups. Fifteen tissue expanders were explanted in the control group and five in the dual-port cohort (32.6% versus 10.6%, P = 0.012). All bacteria in the control group failures were either methicillin-resistant Staphylococcus aureus or Staphylococcus epidermidis, whereas failures in the dual-port group varied. Conclusion: Treatment of routine, early cultures from a dual-port expander led to a statistically significant decrease in tissue expander explantation.

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Section: Discussionsupporting

confidence: 86%