Infection in breast implants

Pittet, Brigitte; Montandon, Denys; Pittet, Didier

doi:10.1016/s1473-3099(05)01281-8

Cited by 145 publications

(109 citation statements)

References 140 publications

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“…The risk of infection is up to ten times higher in patients with cancer undergoing IBBR than in those having cosmetic augmentation20. Wound infection developed in seven breasts in the present cohort, leading to removal of the implant and/or ADM in five instances.…”

Section: Discussionmentioning

confidence: 72%

Predictors of complications after direct-to-implant breast reconstruction with an acellular dermal matrix from a multicentre randomized clinical trial

Negenborn

Dikmans

Bouman

et al. 2018

British Journal of Surgery

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BackgroundIn the multicentre randomized trial BRIOS (Breast Reconstruction In One Stage), direct‐to‐implant (DTI) breast reconstruction with an acellular dermal matrix (ADM) was associated with a markedly higher postoperative complication rate compared with two‐stage tissue expander/implant breast reconstruction. This study aimed to identify factors that contribute to the occurrence of complications after DTI ADM‐assisted breast reconstruction.MethodsData were obtained from the BRIOS study, including all patients treated with DTI ADM‐assisted breast reconstruction. Logistic regression analyses were performed to identify factors predictive of postoperative complications.ResultsFifty‐nine patients (91 breasts) were included, of whom 27 (35 breasts) developed a surgical complication. Reoperations were performed in 29 breasts (32 per cent), with prosthesis removal in 22 (24 per cent). In multivariable analyses, mastectomy weight was associated with complications (odds ratio (OR) 1·94, 95 per cent c.i. 1·33 to 2·83), reoperations (OR 1·70, 1·12 to 2·59) and removal of the implant (OR 1·55, 1·11 to 2·17). Younger patients (OR 1·07, 1·01 to 1·13) and those who received adjuvant chemotherapy (OR 4·83, 1·15 to 20·24) more frequently required reoperation. In univariable analyses, adjuvant radiotherapy showed a trend towards more complications (OR 7·23, 0·75 to 69·95) and removal of the implant (OR 5·12, 0·76 to 34·44), without reaching statistical significance.ConclusionBreast size appeared to be the most significant predictor of complications in DTI ADM‐assisted breast reconstruction. The technique should preferably be performed in patients with small to moderate sized breasts. Registration number: NTR5446 ( http://www.trialregister.nl).

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Section: Discussionmentioning

confidence: 72%

Predictors of complications after direct-to-implant breast reconstruction with an acellular dermal matrix from a multicentre randomized clinical trial

Negenborn

Dikmans

Bouman

et al. 2018

British Journal of Surgery

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“…In contrast, none of the 65 culture-confirmed silicone breast infections reported by Ahn et al grew S. aureus (659). The true incidence of S. aureus infection in breast prostheses is unknown, as there is currently no surveillance network that records the total number of mammoplasties and infections (660).…”

Section: Infections Involving Other Prosthetic Devicesmentioning

confidence: 96%

Staphylococcus aureus Infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management

et al. 2015

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SUMMARY Staphylococcus aureus is a major human pathogen that causes a wide range of clinical infections. It is a leading cause of bacteremia and infective endocarditis as well as osteoarticular, skin and soft tissue, pleuropulmonary, and device-related infections. This review comprehensively covers the epidemiology, pathophysiology, clinical manifestations, and management of each of these clinical entities. The past 2 decades have witnessed two clear shifts in the epidemiology of S. aureus infections: first, a growing number of health care-associated infections, particularly seen in infective endocarditis and prosthetic device infections, and second, an epidemic of community-associated skin and soft tissue infections driven by strains with certain virulence factors and resistance to β-lactam antibiotics. In reviewing the literature to support management strategies for these clinical manifestations, we also highlight the paucity of high-quality evidence for many key clinical questions.

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“…Sin embargo, no hay características clínicas que permitan distinguirla de otras etiologías infecciosas subagudas o crónicas de baja virulencia, como Sthaphylococcus coagulasa negativa. El diagnóstico debe sospecharse en aquellos pacientes con En 1950 se comenzó a emplear silicona líquida, comprobándose con el tiempo la dispersión de la misma a través de la mama causando mastitis, destrucción del parénquima mamario, drenaje percutáneo de la silicona y migración abdominal del polímero 1 .…”

Section: Discussionunclassified

Infección protésica mamaria por Mycobacteriumfortuitum en una paciente con lupus eritematoso sistémico

Lizaso¹,

Garcı́a²,

Aguirre³

et al. 2011

Rev. chil. infectol.

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Breast implant infection by Mycobacterium fortuitum in a patient with systemic lupus erythematosusIn recent decades there has been an increase in the number of breast implants for reconstruction and cosmetic purposes. Infection is a severe complication mostly caused by Staphylococcus aureus or coagulase-negative staphylococci. Mycobacteria are an infrequent cause of infection in this type of surgery. We describe a case of Mycobacterium fortuitum infection in a patient with lupus, subjected to a prosthetic replacement. These patients are more prone to unusual opportunistic infections. Treatment always requires both removal of prosthetic material and antibiotic therapy.Key words: Breast implants; atypical mycobacterial infection; systemic lupus erythematosus; Mycobacterium fortuitum.Palabras clave: Implantes mamarios, infecciones por micobacterias atípicas, Mycobacterium fortuitum. Caso clínicoP aciente con 50 años de edad, con diagnóstico de lupus eritematoso sistémico (LES) hacía cuatro años. Durante su evolución presentó como intercurrencia un síndrome antifosfolipídico y nefritis lúpica que requirió tratamiento con anticoagulantes orales, azatioprina 100 mg/día, hidroxicloroquina 200 mg/día y prednisona 20 mg/día en dosis decreciente. En el año 1996 se le practicó una mastectomía bilateral por antecedentes familiares directos de neoplasia mamaria y hallazgos mamográfi cos de micro-calcifi caciones agrupadas en ambas mamas. Con diagnóstico histopatológico de displasia severa se procedió a la colocación de prótesis mamarias texturizadas por vía submuscular. En agosto de 2008 fue sometida a un recambio protésico mamario bilateral, por encapsulamiento y retracción cutánea, colocándose prótesis texturizadas por vía retromuscular con incisión inframamaria. Al mes del procedimiento, comenzó con equivalentes febriles, tumefacción y eritema en ambas mamas. Se realizó una ecografía de tejidos blandos que demostró una colección periprotésica derecha evidente y mínima contralateral. Se le indicó reposo, hielo y anti-infl amatorios. Luego de una mejoría transitoria recrudeció el cuadro por lo que se le prescribió amoxicilina/ác. clavulánico (3 gr/ día) que luego fue modifi cado a ciprofl oxacina asociada a clindamicina. Posteriormente, consultó a un médico infectólogo quien le aconsejó retiro de ambas prótesis mamarias dado el hallazgo ecográfi co de colecciones bilaterales; sin embargo, la paciente no accedió. Evolucionó posteriormente con drenaje espontáneo de secreción en la mama derecha, por lo que se realizó una evacuación quirúrgica, obteniéndose un líquido de aspecto citrino que se envió a cultivo (Figuras 1 y 2).

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Infection in breast implants

Cited by 145 publications

References 140 publications

Predictors of complications after direct-to-implant breast reconstruction with an acellular dermal matrix from a multicentre randomized clinical trial

Predictors of complications after direct-to-implant breast reconstruction with an acellular dermal matrix from a multicentre randomized clinical trial

Staphylococcus aureus Infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management

Infección protésica mamaria por Mycobacteriumfortuitum en una paciente con lupus eritematoso sistémico

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