Prosthesis Salvage in Breast Reconstruction Patients with Periprosthetic Infection and Exposure

Prince, Melanie D.; Suber, Jessica; Aya-ay, Melanie L.; Cone, Jeffrey D.; Greene, John N.; Smith, David J.; Smith, Paul D.

doi:10.1097/prs.0b013e3182361fbd

Cited by 65 publications

(69 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The classification of the infection degree was performed in all seven studies; and even though this stratification was not uniform, the advanced level was among the main causes of prosthetic loss. In four studies, the severity of infection implicated in removal of the prosthesis and late reconstruction, in case the patient desired so [13][14][15][16][17][18][19] . The rate of saved prostheses after stratification of complications -including the use of the same prosthesis or its replacement by another device -varied from 45 to 100%.…”

Section: Resultsmentioning

confidence: 99%

“…However, in Prince et al 15 , removing the most severe cases presented higher rates of saved prostheses. Stratification of postoperative complications, in Bennet et al 16 , is similar to Prince et al 15 and Peled et al 14 , in which the management of severe infection cases consisted in prosthetic removal and late reconstruction. In the other cases, there was an attempt to save the prostheses, with or without the support of myocutaneous flaps, depending on the quality of the remaining skin.…”

Section: Yii and Khoomentioning

confidence: 99%

“…Three of the seven studies with direct data presented positive Gram-bacteria of the skin as a statistically significant factor of non-success among the attempts of saving the prostheses 13,15,19 , and Staphylococcus Aureus was the most responsible one for it. Radiotherapy appears in second place as the cause of implant loss.…”

Section: Yii and Khoomentioning

confidence: 99%

“…Therefore, they are objective and have great reproducibility, in addition to being challenging, once that for several decades, on an imminent risk situation, the irrefutable procedure was to remove the prosthesis 35 . For Prince et al 15 , cases of severe infection (pus associated with signs of local or systemic severe inflammation) consisted in the only situation where there was not an attempt of saving the prosthesis. Among the 60 patients with complications and indication of surgical approach, 43 received recommendations for trying to save the prosthesis.…”

Section: Yii and Khoomentioning

confidence: 99%

“…All the patients were candidate to one or more attempts of salvage implants, unless they refused 15 (62%) Radiotherapy Prince 15 , 2012…”

Section: Leukocytosis During Admission and Cultures With Methicillin-mentioning

confidence: 99%

See 4 more Smart Citations

Management of complications in reconstructive mammoplasties with prostheses: systematic review

Hassan¹,

Urban²

2017

Rev. Bras. Mastol. (Impr.)

View full text Add to dashboard Cite

Objective: The aims of this study were to determine the main managements of surgical complications in reconstructive mammoplasties with prostheses through a systematic literature review, and to evaluate the effectiveness in preserving the reconstruction. The secondary objective was to analyze factors regarding prosthetic loss. Methods: We used the MedLine database through the following expressions: "breast cancer" or "breast neoplasm" or "breast and neoplasm" or "breast and cancer" and "implants complications" or "implants and complications". The reference period for these studies comprised January 2000 to July 2016. Results: Of the 856 articles found, seven were included to analyze the applied protocols. The rate of saved prostheses after stratification of complications and use of managements varied from 45 to 100%, depending on the degree of complication. Other 12 articles that evaluated the factors associated with prosthetic loss were secondarily chosen. Radiotherapy was considered the most frequent factor and was found in seven studies. The number of lost prostheses varied from 0.9 to 22.7% in such studies. Conclusion: There is still no agreement on how to manage complications of reconstructive mammoplasties with prostheses. The decision remains a challenge, and therefore surgeons need to know the possible conducts in order to establish the most appropriate treatment.KEYWORDS: Breast cancer; mastectomy; mammaplasty; breast implantation. ABSTRACT RESUMOObjetivos: O objetivo principal deste estudo foi determinar, por meio de revisão sistemática da literatura, as principais condutas nas complicações cirúrgicas de mastectomias reconstruídas com próteses, bem como avaliar a eficácia em preservar a reconstrução. O objetivo secundário foi analisar fatores relacionados à perda da prótese. Métodos: Foi empregado o banco de dados do MedLine, utilizando as expressões: breast cancer, ou breast neoplasm ou breast and neoplasm ou breast and cancer e implants complications ou implants and complications. O período de referência desses estudos foi de janeiro de 2000 até julho de 2016. Resultados: Dos 856 artigos encontrados, 7 foram incluídos para análise dos protocolos de condutas aplicados. A taxa de próteses salvas após estratificação das complicações e aplicação das condutas variou de 45 a 100%, a depender do grau de complexidade. Foram selecionados, secundariamente, outros 12 artigos que avaliaram fatores associados à perda da prótese. A mais frequente foi a radioterapia com 7 estudos. O número de próteses perdidas variou entre 0,9 e 22,7% nesses estudos. Conclusão: Ainda não existe unanimidade no manejo das complicações de mastectomias reconstruídas com próteses. Portanto, a decisão permanece desafiadora e o cirurgião necessita conhecer as possíveis condutas para definir a mais apropriada. PALAVRAS-CHAVE:Câncer de mama; mastectomia; reconstrução da mama; implante de mama. REVIEW ARTICLEMastology, 2017;27(2):156-63 157Management of complications in reconstructive mammoplasties with prostheses: systematic review

show abstract