Kim Minseo, Ku Inhoe, Jin Ung Sik
Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul, Korea.
Arch Plast Surg. 2021 Mar;48(2):189-193. doi: 10.5999/aps.2020.01144. Epub 2021 Mar 15.
Breast implant insertion is one of the most commonly used methods for breast reconstruction after total mastectomy. However, infection is a common postoperative complication of implant insertion. In most cases, these infections can be managed with antibiotics and supportive therapy. However, severe septic conditions, such as toxic shock syndrome (TSS), can sometimes occur. TSS is an extremely rare but life-threatening complication, for which early diagnosis and proper management play a crucial role in determining patients' outcome. Although only 16 cases of TSS after breast implant insertion have been reported in the literature, most of those cases involved a serious clinical course. The reason for the seriousness of the clinical course of TSS in these cases is that the initial impression and presentation of these patients are nonspecific, and patients can easily be misdiagnosed as having a simple upper respiratory infection, causing the underlying condition to be neglected. Herein, we present two patients who were diagnosed with TSS after receiving breast reconstruction surgery via a silicone implant after total mastectomy. Both patients were misdiagnosed at the initial examination since they showed no local infectious signs on the postoperative wound.
乳房植入是全乳切除术后乳房重建最常用的方法之一。然而，感染是植入术后常见的并发症。在大多数情况下，这些感染可用抗生素和支持性治疗来处理。然而，有时会出现严重的脓毒症情况，如中毒性休克综合征（TSS）。TSS是一种极其罕见但危及生命的并发症，早期诊断和妥善处理对决定患者的预后起着关键作用。尽管文献中仅报道了16例乳房植入术后发生TSS的病例，但其中大多数病例临床过程严重。这些病例中TSS临床过程严重的原因是这些患者最初的表现和症状不具特异性，患者很容易被误诊为单纯的上呼吸道感染，从而导致潜在病情被忽视。在此，我们报告两例在全乳切除术后通过硅胶植入进行乳房重建手术后被诊断为TSS的患者。两名患者在初次检查时均被误诊，因为她们术后伤口没有局部感染迹象。
