The Reuse of Tissue Expanders in Developing Countries

Westreich, Melvyn; Yeschua, Ruth

doi:10.1097/00006534-199501000-00043

Cited by 1 publication

(2 citation statements)

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“…These tips could be used to decrease the risk of infection also increase the number of women predisposed to breast plastic surgery and in particular to immediate breast reconstruction in developing countries. We do not recommend using reused expanders to bring down health care costs in developing countries due to the higher rate of complications with related care costs, as mentioned in several reports [22,23].…”

Section: Discussionmentioning

confidence: 92%

“…However, the reuse of expanders in developing countries is not recommended, as reports have demonstrated an increased incidence of complications [22] and postimplantation development of clinical symptomatology with fatigue, fever, shortness of breath, and pleural effusion, compatible with infection [23]. According to Anger [22], the higher number of complications associated with the reused expander could lead to greater health care spending than would the purchase of a new expander.…”

Section: Risk Factorsmentioning

confidence: 99%

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Infections in breast implants: a review with a focus on developing countries

Rubino

Brongo

Pagliara

et al. 2014

J Infect Dev Ctries

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The risk of surgical site infection is always present in surgery; the use of prosthetic materials is linked to an increased possibility of infection. Breast augmentation and breast reconstruction with implants are gaining popularity in developing countries. Implant infection is the main complication related to breast aesthetic and reconstructive surgery. In the present paper, we reviewed the current microbiological knowledge about implant infections, with particular attention to risk factors, diagnosis, clinical management, and antibiotic prophylaxis, focusing on reports from developing countries. After breast aesthetic surgery, up to 2.9% of patients develop a surgical site infection, with an incidence of 1.7% for acute infections and 0.8% for late infections. The rate of surgical site infection after post-mastectomy breast reconstruction is usually higher, ranging from 1% to 53%. The clinical features are not constant, and bacterial culture with antibiogram is the gold standard for diagnosis and for identification of antibiotic resistance. While waiting for culture results, empiric therapy with vancomycin and extendedspectrum penicillins or cephalosporins is recommended. Some patients require removal of the infected prosthesis. The main methods to bring down the risk of infection are strict asepsis protocol, preoperative antibiotic prophylaxis, and irrigation of the surgical pocket and implant with an antibiotic solution.Key words: breast implant infections; acute infections; late infections; fungal infections; rare infections. EpidemiologyImplant infection is the main complication related to breast aesthetic and reconstructive surgery [1]. After breast aesthetic augmentation, up to 2.9% of women are affected by infection [2], with an incidence of 1.7% for acute infections versus an incidence of 0.8% for late infections, as confirmed by retrospective cohort studies with long-term follow-ups [1]. In developing countries, this problem is even more prevalent; surgery has a 50% rate of possible complications, of which infection is the main complication [3]. The rate of surgical site infection after post-mastectomy breast reconstruction is usually higher, ranging from 1% to 53% [4,5]. In breast reconstruction, a higher rate of infection was reported with expander implants compared to reconstruction with autologous tissue such as latissimus dorsi flaps [6]. The highest rates were found in women undergoing immediate reconstruction [4]. The reported number of infections after mammary augmentation and reconstruction is lower than the real incidence, because of the lack of a surveillance network of patients based on long-time follow-ups. The economic commitment for management of implant infections is significant. Kirkland et al. [7] reported an increase of hospital permanence for surgical site infection of 6.5 days, with related health care costs. In the United States, health care costs for surgical site infection after breast surgery were estimated to be about $4,091 [7], or $574 in the outpatient setting [9]...

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Section: Discussionmentioning

confidence: 92%