Takeuchi Mika, Kuwahara Masamitsu, Ando Junji, Miyata Riyo, Harada Masayuki, Kanagawa Saori
Division of Plastic Surgery, Nara Medical University Hospital, 840 Shijocho, Kashihara, Nara, 634-8522, Japan.
Int J Surg Case Rep. 2021 May;82:105860. doi: 10.1016/j.ijscr.2021.105860. Epub 2021 Apr 5.
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].
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.
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.
Intermittent suction worked well in this patient and, thus, warrants further study.
基于植入物的乳房重建是一种广泛开展的手术。然而,假体易受感染,目前尚无既定的治疗指南。在本病例中,通过将持续冲洗吸引改为持续冲洗间歇吸引成功挽救了假体。本病例报告已按照SCARE标准[1]进行报告。
一名50岁女性患者在乳腺癌手术后接受了基于植入物的乳房重建。一个月后,左乳房假体感染并形成脓肿。术后进行了手术治疗和持续冲洗。然而,术后几天发现感染复发。将持续冲洗改为持续冲洗间歇吸引,成功控制了感染。
尚未确定限制持续冲洗吸引效果的因素。在持续吸引中可能会形成流入/流出分流途径,因此可能无法进行充分的清洁。另一方面,间歇吸引中伤口内积水可能有助于清洁。
间歇吸引在该患者中效果良好,因此值得进一步研究。