Washington, D.C. From the Department of Plastic Surgery, Georgetown University Hospital.
Plast Reconstr Surg. 2010 Apr;125(4):1074-1084. doi: 10.1097/PRS.0b013e3181d17fff.
In 2004, the senior author (S.L.S.) published an algorithm for the management of breast device infection and/or exposure. The purpose of this study was to build on the authors' prior experience by expanding the cohort of patients and to identify risk factors for failed breast device salvage and recurrent infection/exposure.
A retrospective study was carried out on a single plastic surgeon's experience between 1993 and 2008. Patients with infected and/or exposed breast devices were classified into one of seven groups and salvage rates were calculated. Patient demographics and wound culture pathogens were analyzed as possible risk factors for device loss and recurrent infection/exposure.
Over a 15-year period, the senior author managed 69 patients with 87 events of breast device infection and/or exposure. The overall salvage rate was 64.4 percent. Failed device salvage was significantly associated with the presence of atypical pathogens, such as gram-negative rods, methicillin-resistant Staphylococcus aureus, and Candida parapsilosis. Recurrent device infection and/or exposure was significantly associated with a history of radiotherapy or the presence of S. aureus on wound culture.
Salvage of the infected and/or exposed breast prosthesis remains a challenging yet viable option for a subset of patients. Relative contraindications include atypical pathogens on wound culture, such as gram-negative rods, methicillin-resistant S. aureus, and C. parapsilosis. Patients with a prior device infection and/or exposure and a history of either radiotherapy or S. aureus on wound culture should be monitored closely for signs of recurrence and managed cautiously in the setting of elective breast surgery.
2004 年，资深作者（S.L.S.）发表了一篇关于乳房植入物感染和/或外露的管理算法。本研究的目的是在前人经验的基础上扩大患者群体，并确定乳房植入物挽救失败和再次感染/外露的风险因素。
对一位整形外科医生在 1993 年至 2008 年间的经验进行了回顾性研究。将感染和/或外露乳房植入物的患者分为七组，并计算挽救率。分析患者的人口统计学数据和伤口培养病原体，以确定导致器械丢失和再次感染/外露的可能风险因素。
在 15 年期间，资深作者管理了 69 名患者的 87 例乳房植入物感染和/或外露事件。总体挽救率为 64.4%。器械挽救失败与非典型病原体（如革兰氏阴性杆菌、耐甲氧西林金黄色葡萄球菌和近平滑念珠菌）的存在显著相关。再次发生装置感染和/或外露与放疗史或伤口培养中存在金黄色葡萄球菌显著相关。
对于一部分患者来说，挽救感染和/或外露的乳房假体仍然是一个具有挑战性但可行的选择。相对禁忌症包括伤口培养中的非典型病原体，如革兰氏阴性杆菌、耐甲氧西林金黄色葡萄球菌和近平滑念珠菌。对于有先前装置感染和/或外露史、放疗史或伤口培养中金黄色葡萄球菌阳性的患者，应密切监测复发迹象，并在择期乳房手术中谨慎处理。
