Plastic and Reconstructive Surgery department-I.R.C.C.S. "Regina Elena" National Cancer Institute, Rome, Italy.
Plastic and Reconstructive Surgery department-I.R.C.C.S. "Regina Elena" National Cancer Institute, Rome, Italy.
Clin Breast Cancer. 2024 Jan;24(1):65-71. doi: 10.1016/j.clbc.2023.09.015. Epub 2023 Sep 29.
implants are the most popular means of restoring the breast mound after mastectomy; the most feared complication is implant infection accounting for 4.8% to 35.4% of cases. Various antibiotic regimens or other surgical revisions to treat implant infections have been reported, but their failure rates are unacceptable. Implant removal is subsequently the most common recourse for managing prosthesis infections. we report preliminary results of infected breast implant salvage using our Regina Elena Institute (REI) protocol.
Since June 2021, a prospective single-centre study has been ongoing for patients burdened by implant infection or exposure. All qualifying participants underwent our REI protocol. They receive a temporary smooth implant and 1 week of implant's pocket irrigation with antibiotic solution along with systemic antibiotic and then a new permanent prosthesis positioning.
Ten of whom completed at least 6 months of follow-up and were eligible for this preliminary analysis. Overall, the REI protocol was applied to 13 breasts. No infections relapsed during the 6-month minimum follow-up intervals; and no early capsular contraction was evident, resulting in good cosmetic outcomes for every treated breast.
The smooth-surfaced implant's sizer helps maintain tissue expansion, preventing skin retraction; and the slightly smaller diameters used (compared with originals) facilitate antibiotic wash distribution. Combining a targeted systemic antibiotic and a topical agent is the best way to optimise infection resolution. This preliminary analysis has clear limitations. A larger population is warranted to increase the level of evidence. Longer follow-up is also advisable to monitor for delayed infection recurrence.
植入物是乳房切除术后重建乳房丘的最流行手段;最令人恐惧的并发症是植入物感染,占 4.8%至 35.4%的病例。已经报道了各种抗生素方案或其他手术修正来治疗植入物感染,但它们的失败率是不可接受的。因此,去除植入物是管理假体感染的最常见方法。我们报告使用我们的 Regina Elena 研究所 (REI) 方案治疗感染性乳房植入物的初步结果。
自 2021 年 6 月以来,一项针对患有植入物感染或暴露的患者的前瞻性单中心研究一直在进行。所有符合条件的参与者都接受了我们的 REI 方案。他们接受临时光滑植入物和 1 周的抗生素溶液植入物袋冲洗,同时给予全身抗生素,然后重新定位新的永久性假体。
其中 10 人完成了至少 6 个月的随访,符合本初步分析的条件。总体而言,REI 方案应用于 13 个乳房。在 6 个月的最短随访期间,没有感染复发;并且没有明显的早期包膜收缩,使每个治疗的乳房都有良好的美容效果。
光滑表面植入物的测量器有助于维持组织扩张,防止皮肤回缩;并且使用的直径略小(与原始直径相比)有助于抗生素冲洗的分布。联合靶向全身抗生素和局部药物是优化感染解决的最佳方法。本初步分析有明显的局限性。需要更大的人群来提高证据水平。还建议进行更长时间的随访,以监测迟发性感染复发的情况。