Classification of breast tissue expander infections: Back to the basics. Issue 2 (18th May 2019)

• Record Type: Journal Article
• Authors: Kraenzlin, Franca S.; Saunders, Heather; Aliu, Oluseyi; Cooney, Damon; Rosson, Gedge D.; Sacks, Justin M.; Broderick, Kristen; Manahan, Michele A.
• Is Part Of: Journal of surgical oncology. Volume 120:Issue 2(2019)
• Page Start: 142
• Page End: 147
• Publication Date: 2019-05-18
• Subjects: breast reconstruction -- tissue expander‐based breast reconstruction -- tissue expander infections; Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.25500
• Languages: English
• ISSNs: 0022-4790

Abstract

Abstract: Background: Infections following tissue expander (TE) placement are frequent complications in breast reconstruction. While breast surgery is a clean case, implant‐based breast reconstruction has rates of infection up to 31%, decidedly higher than the typical 1% to 2% rate of surgical site infections (SSI). Few authors use the Center for Disease Control's (CDC) SSI definition for TE infections. We highlight how adoption of a consistent definition of TE infection may change how infections are researched, categorized, and ultimately managed. Methods: Two researchers with definitional discrepancies of infection performed an independent analysis of all postmastectomy patients receiving TEs (n = 175) in 2017. Results: Researcher One, using a clinical definition, delineated an infection rate of 19.4%. Antibiotics alone successfully treated 50% of cases. Researcher Two found an infection rate of 13.7% using CDC criteria. These infections were further delineated by a SSI rate of 6.3% and a TE infection rate post port access of 7.4%. Only 45.5% SSI's and 15.4% of TE infections were salvaged with antibiotics alone. Conclusions: Rigorous adoption of CDC criteria for infection characterization in published research will help standardize the definition of infection and allow surgeons to create evidence‐based infection prevention regimens.