Classification of breast tissue expander infections: Back to the basics

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)142-147
Number of pages6
JournalJournal of Surgical Oncology
Volume120
Issue number2
DOIs
StatePublished - Aug 1 2019

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Keywords

  • breast reconstruction
  • tissue expander infections
  • tissue expander-based breast reconstruction

ASJC Scopus subject areas

  • Surgery
  • Oncology

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