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Prompt Replacement May Work in Some Implant Infections

Review of post-mastectomy patients shows good results following immediate salvage surgery

TUESDAY, Sept. 25 (HealthDay News) -- The traditional approach to breast infections following implant surgery entails removing the implant and waiting until the infection clears to replace it. However, surgical exchange of the implant without delay may be appropriate in some patients who have had breast reconstruction following mastectomy, according to a presentation of cases in the Sept. 1 issue of Plastic and Reconstructive Surgery.

Jin K. Chun, M.D., and Matthew R. Schulman, M.D., of the Mount Sinai Medical Center in New York City, reviewed nine consecutive cases of infected breast implants in eight patients. All had undergone immediate breast reconstruction following mastectomy for cancer. The mean age of patients was 47.3 years.

The treatment involved removing the implant and abrading or curetting the capsule to remove fibrinous material or infectious peel, without formal capsulectomy. The surgeons then irrigated the pocket with 6 to 9 liters of saline and inserted a new implant, generally of the same type and size. Patients were given intravenous antibiotics pre- and post-operatively. All prostheses responded well and remained intact and without further infection at the time of writing.

"We hope that our experience challenges the belief that severe infection mandates explantation. However, the decision to intervene surgically in an attempt to salvage severely infected breast prostheses is a difficult one that must consider patient factors, tissue factors, and the need for chemotherapy," the authors write.

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