Successful salvage of an infected breast prothesis by changing from continuous to intermittent suction under continuous irrigation. (May 2021)

• Record Type: Journal Article
• Authors: Takeuchi, Mika; Kuwahara, Masamitsu; Ando, Junji; Miyata, Riyo; Harada, Masayuki; Kanagawa, Saori
• Is Part Of: International journal of surgery case reports. Volume 82(2021)
• Publication Date: 2021-05
• Subjects: TE Tissue Expander; Breast reconstruction -- Breast implant -- Breast prothesis -- Infection; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2021.105860
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: Continuous irrigation does not always salvage infected breast implants. It is unclear whether continuous or intermittent suction is more effective. We salvaged a breast implant by changing from continuous to intermittent suction. Intermittent suction worked well in this patient and it is worthy of further studies. Abstract: Introduction: Implant-based breast reconstruction is a widely performed procedure. However, prostheses are susceptible to infection and there are currently no established guidelines on treatment. In the present case, a prosthesis was salvaged by changing from continuous irrigation and suction to continuous irrigation and intermittent suction. This case report has been reported in line with the SCARE criteria [1 ]. Presentation of case: A 50-year-old female patient underwent implant-based breast reconstruction following surgery for breast cancer. One month later, the left breast prosthesis was infected with abscesses. Surgical treatment and continuous irrigation were performed as postoperative therapy. However, recurrent infection was detected a few days after surgery. Continuous irrigation was changed to continuous irrigation with intermittent aspiration, which successfully controlled the infection. Discussion: Factors that limit the effectiveness of continuous irrigation and aspiration have not yet been identified. Inflow/discharge shunt routes may be established in continuous aspiration, and, thus, sufficient cleaning may not be possible. On the other hand, the storage of water throughout the wound in intermittent aspiration may facilitate cleaning. Conclusion: Intermittent suction worked well in this patient and, thus, warrants further study.