Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Stanford, CA, United States; Royal College of Surgeons in Ireland, St. Stephen's Green, Dublin, Ireland.
Section of Plastic and Reconstructive Surgery, University of Chicago Medicine, Chicago, IL, United States; University of Nebraska Medical Center, Omaha, NE, United States.
J Plast Reconstr Aesthet Surg. 2022 Sep;75(9):3060-3067. doi: 10.1016/j.bjps.2022.04.087. Epub 2022 May 2.
Textured tissue expanders (TTEs) were introduced to limit migration and reduce capsular contracture, which were inherent to smooth tissue expanders (STEs). Previous reports suggest that textured devices have increased rates of bacterial contamination and biofilm formation in comparison with smooth devices. Recently, the relative increased association of anaplastic large cell lymphoma (ALCL) with textured versus smooth devices has led to increased adoption of smooth devices. The aim of our study is to evaluate the post-operative surgical site infection (SSI) rates of STEs versus TTEs.
A retrospective case series was conducted at a single academic teaching hospital from April 2016 to December 2019. The primary outcome variable was the development of a post-operative SSI.
One hundred seventy-seven breasts underwent reconstruction with TTEs and 109 breasts underwent reconstruction with STE. In total, 54 SSIs were recorded (n = 34 TTE; n = 20 STE), with the majority of infections occurring within the first 30 post-operative days (TTE 65%, STE 70%). There was no statistically significant difference in overall post-operative infection rates between TTE and STE groups when broken down into the following time points: <30 day, 30-60 days, and >90 days (p = 0.924). There was no statistically significant difference between infection type (superficial vs. deep, p = 0.932), infection management (medical, surgical, or both, p = 0.409) or salvage results (p = 0.078) seen in STE versus TTE cohort. On multivariate analysis, seroma history was associated with SSI development (OR 3.18, p = 0.041).
There was no significant difference in the rate of post-operative SSI following breast reconstruction with STE relative to TTE.
为了限制迁移和减少包膜挛缩，组织扩张器（TE）被引入，而包膜挛缩是平滑组织扩张器（STE）所固有的。先前的报告表明，与平滑器械相比，纹理器械的细菌污染和生物膜形成率更高。最近，间变性大细胞淋巴瘤（ALCL）与纹理器械的相对增加关联导致平滑器械的使用增加。我们研究的目的是评估 STE 与 TTE 术后手术部位感染（SSI）的发生率。
在 2016 年 4 月至 2019 年 12 月期间，在一家学术教学医院进行了回顾性病例系列研究。主要观察变量是术后 SSI 的发生。
177 例乳房接受 TTE 重建，109 例乳房接受 STE 重建。共有 54 例 SSI 记录（n=34 TTE；n=20 STE），大多数感染发生在术后 30 天内（TTE 为 65%，STE 为 70%）。当按以下时间点细分时，TTE 和 STE 组之间的总术后感染率没有统计学上的显著差异：<30 天、30-60 天和>90 天（p=0.924）。在感染类型（浅表性与深部性，p=0.932）、感染管理（药物治疗、手术治疗或两者兼有，p=0.409）或挽救结果（p=0.078）方面，STE 与 TTE 队列之间没有统计学上的显著差异。多变量分析显示，血清肿病史与 SSI 发生有关（OR 3.18，p=0.041）。
与 TTE 相比，STE 用于乳房重建后 SSI 的发生率没有显著差异。
