The Fate of Breast Implants with Infections Around Them

Courtiss, Eugene H.; Goldwyn, Robert M.; Anastasi, Gaspar W.

doi:10.1097/00006534-197906000-00006

Cited by 126 publications

(25 citation statements)

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“…19,23 A few cases of breast infection caused by S. lugdunensis after plastic surgery, e.g., mammoplasty and mastectomy for breast cancer, have been reported. [24][25][26][27] Moreover, S. simulans, which was identified in one of the present breast implant infection cases, has not been reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

The microbial epidemiology of breast implant infections in a regional referral centre for plastic and reconstructive surgery in the south of France

Seng

Bayle

Alliez

et al. 2015

International Journal of Infectious Diseases

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Section: Discussionmentioning

confidence: 99%

The microbial epidemiology of breast implant infections in a regional referral centre for plastic and reconstructive surgery in the south of France

Seng

Bayle

Alliez

et al. 2015

International Journal of Infectious Diseases

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“…17 During the past 20 years, there has been a growing awareness that a periprosthetic infection or exposure does not necessarily condemn an implant to removal. 7, 19 Courtiss et al 7 reported that in the setting of periprosthetic infection, successful implant salvage was achieved in 13 of 29 implants by passive wound drainage and antibiotic therapy. Courtiss et al 7 subsequently recommended that active intervention is necessary to save implants with periprosthetic infection 13 and that capsulotomy and dissection should be performed to avoid skin tension during treatment of threatened implant exposure.…”

Section: Discussionmentioning

confidence: 99%

“…7, 19 Courtiss et al 7 reported that in the setting of periprosthetic infection, successful implant salvage was achieved in 13 of 29 implants by passive wound drainage and antibiotic therapy. Courtiss et al 7 subsequently recommended that active intervention is necessary to save implants with periprosthetic infection 13 and that capsulotomy and dissection should be performed to avoid skin tension during treatment of threatened implant exposure. 15 Others have discussed salvage as an option, although some authors suggest that the management of such situations is a clinical judgment with few additional established guidelines.…”

Section: Discussionmentioning

confidence: 99%

The Infected or Exposed Breast Implant: Management and Treatment Strategies

Spear

Howard

Boehmler

et al. 2004

Plastic and Reconstructive Surgery

165

114

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Among the potential complications associated with the use of breast implants are the risks of periprosthetic infection and device extrusion. There is little published information about the effective management of these situations. Conservative recommendations include antibiotic therapy and removal of the implant until resolution of the infection or until the wound has healed. A retrospective review identified patients with periprosthetic infection or threatened or actual device exposure treated by the senior author. Twenty-four patients encompassing 26 affected prostheses were available for review and were classified into seven groups based on initial presentation as follows: group 1, mild infection (n = 8); group 2, severe infection (n = 4); group 3, threatened exposure without infection (n = 3); group 4, threatened exposure with mild infection (n = 3); group 5, threatened exposure with severe infection (n = 1); group 6, actual exposure without clinical infection (n = 5); and group 7, actual exposure with infection (n = 2). To salvage the prosthesis in these patients, various treatment strategies were utilized. All patients with a suspected infection or device exposure were started immediately on appropriate antibiotic therapy (oral antibiotics for mild infections and parenteral antibiotics for severe infections). Salvage methods included one or more of the following: antibiotic therapy, débridement, curettage, pulse lavage, capsulectomy, device exchange, primary closure, and/or flap coverage. Twenty (76.9 percent) of 26 threatened implants with infection or threatened or actual prosthesis exposure were salvaged after aggressive intervention. The presence of severe infection adversely affected the salvage rate in this series. A statistically significant difference exists among those patients without infection or with mild infection only (groups 1, 3, 4, and 6); successful salvage was achieved in 18 (94.7 percent) of 19 patients, whereas only two of seven of those implants with severe infection (groups 2, 5, and 7) were salvaged (p = 0.0017). Ten (90.9 percent) of 11 devices with threatened or actual exposure, not complicated by severe infection (groups 3, 4, and 6), were salvaged. Several treatment strategies were developed for periprosthetic infection and for threatened or actual implant exposure. Patients with infection were placed on oral or intravenous antibiotics; those who responded completely required no further treatment. For persistent mild infection or threatened or actual exposure, operative intervention was required, including some or all of the following steps: implant removal, pocket curettage, partial or total capsulectomy, débridement, site change, placement of a new implant, and/or flap coverage; the menu of options varied with the precise circumstances. No immediate salvage was attempted in five cases, due to either severe infection, nonresponding infection with gross purulence, marginal tissues, or lack of options for healthy tissue coverage. Based on the authors' experience, salvage attempts ...

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“…11,12 Symptoms usually manifest during the first postoperative week, but delayed infections have been reported months and even years after augmentation. The risk of infection does not appear to be related to implant surface characteristics (smooth, textured, or polyurethane), filler material (saline, gel, soybean oil), or implant position (submammary or subpectoral).…”

Section: Infectionmentioning

confidence: 99%

Managing Complications of Breast Augmentation

Handel¹

2001

Perspectives in Plastic Surgery

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Augmentation mammaplasty is an extremely popular operation and yields a high degree of patient satisfaction. However, a certain number of individuals develop side effects and complications that require additional treatment. Some complications are events that may occur in association with any surgical procedure, whereas others are specifically related to the breast prosthesis. Because these problems occur relatively frequently, plastic surgeons in clinical practice must be familiar with their diagnosis and treatment. The purpose of this article is to review the diagnosis and management of complications following breast augmentation. Even in the face of a suboptimal result or complication, most augmentation patients wish to undergo corrective surgery and preserve their implants. With appropriate management, a good outcome can be achieved in nearly all cases.

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The Fate of Breast Implants with Infections Around Them

Cited by 126 publications

References 0 publications

The microbial epidemiology of breast implant infections in a regional referral centre for plastic and reconstructive surgery in the south of France

The microbial epidemiology of breast implant infections in a regional referral centre for plastic and reconstructive surgery in the south of France

The Infected or Exposed Breast Implant: Management and Treatment Strategies

Managing Complications of Breast Augmentation

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