Antibiotic treatment and prophylaxis of periprosthetic infections: Evaluation of 666 consecutive breast implant removals

Lohmeyer, Jörn Andreas; Jakob, Vivian L.; Keck, Maike; Wittig, Klaus

doi:10.1016/j.bjps.2020.11.005

Cited by 6 publications

(12 citation statements)

References 41 publications

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“…However, Mesa et al 18 believed that P. aeruginosa was the second cause of breast implant infections after S. aureus . Furthermore, Lohmeyer JA et al identified CoNS as the primary cause of clinically insignificant infections of breast implants 9 . In our study, highest rates of MRCNS were predominately found in nose, upper limb, and perineum infection sites.…”

Section: Discussionsupporting

confidence: 56%

“…Once the colonization bacteria break through the barrier, they can invade the body and cause infection 5–7 . Second, infection is a common complication after the application of foreign bodies such as expanders and prostheses 8,9 . In addition, some studies also revealed that the implants contaminated with bacteria were the main cause of infection 10,11 .…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7] Second, infection is a common complication after the application of foreign bodies such as expanders and prostheses. 8,9 In addition, some studies also revealed that the implants contaminated with bacteria were the main cause of infection. 10,11 Hence, the infection has become a great challenge for plastic surgery.…”

Section: Discussionmentioning

confidence: 99%

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Analysis of pathogen distribution and antimicrobial resistance at infected sites in plastic surgery

Jiang

Dai³

et al. 2023

J of Cosmetic Dermatology

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Objective By analyzing the distribution and drug resistance of common pathogen in different sites in plastic surgery to provide reference for clinicians to choose the best antibacterial treatment plan. Methods Pathogens of postoperative infection in plastic surgery from January 2011 to December 2021 were retrospectively analyzed to determine the species and quantity, and to access the trend of each pathogen's detection rate. The antibiotic sensitivity and distribution characteristics of common pathogens were studied in conjunction with the site of infection. Results A total of 1709 bacterial strains were detected, including 1244 gram‐positive bacterial strains and 465 gram‐negative bacterial strains. The main pathogen of perineum was Escherichia coli (E. coli) and Pseudomonas aeruginosa (P. aeruginosa), while Staphylococcus aureus (S. aureus) was the most common pathogen in the other infected sites. The detection rate of methicillin‐resistant S. aureus (MRSA) and methicillin‐resistant coagulase‐negative staphylococcus (MRCNS) was on the rise from 2011 to 2021. No S. aureus and coagulase‐negative staphylococcus (CoNS) strains were resistant to vancomycin. The sensitive rate of S. aureus from all parts and CoNS from all sites except lower limbs and mandible was higher than 80% to linezolid. The resistance rate of S. aureus and CoNS in all parts to penicillin, clindamycin, and erythromycin was high. The susceptibility rate of CoNS in lower mandible was high to gentamicin. Conclusions Staphylococcus aureus was the primary pathogen of gram‐positive bacteria in all site of plastic surgery except perineum, followed by CoNS. The distribution and drug resistance of pathogen in different infection sites were different. We should formulate more accurate and reasonable antibacterial programs according to drug resistance results of various parts to reduce the emergence of resistant strains and effectively prevent and control infection.

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Section: Discussionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

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Analysis of pathogen distribution and antimicrobial resistance at infected sites in plastic surgery

Jiang

Dai³

et al. 2023

J of Cosmetic Dermatology

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“…Altogether, this has prompted many surgeons to use extended courses of antibiotics beyond the perioperative period. 11,12 A survey of 253 plastic surgeons in 2017 revealed that 84% of respondents prescribed postoperative prophylactic antibiotics after IBBA. 13 However, current literature does not provide standardized, evidence-based guidelines for antibiotic prophylaxis after IBBA.…”

mentioning

confidence: 99%

“…Several etiologies for CC have been proposed, including subclinical infection and biofilm formation. Altogether, this has prompted many surgeons to use extended courses of antibiotics beyond the perioperative period 11,12 . A survey of 253 plastic surgeons in 2017 revealed that 84% of respondents prescribed postoperative prophylactic antibiotics after IBBA 13 .…”

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confidence: 99%

The Role of Antibiotic Prophylaxis in Primary and Secondary Implant-Based Breast Augmentation

et al. 2023

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Background The administration of antibiotic prophylaxis for implant-based breast augmentation (IBBA) is commonplace among many plastic surgeons. However, the current literature lacks evidence-based recommendations to support this practice. Although few studies have demonstrated a reduction in surgical site infection (SSI) and capsular contracture (CC) with antibiotics, these studies were underpowered and poorly designed. The aim of this study was to provide an updated comprehensive analysis of the literature to revisit the benefit of antibiotic prophylaxis. Methods A comprehensive literature search of PubMed, Embase, Web of Science, and Cochrane was performed from January 1989 to January 2022. Observational studies and randomized controlled trials (RCTs) involving primary and secondary IBBA and use of antibiotic prophylaxis were included. Primary outcomes included SSI and CC. Study quality and risk of bias were evaluated using standardized tools. A meta-analysis was performed for eligible studies. Trial Sequential Analysis was used to assess the need for future RCTs. Results A total of 5 studies (3 observational and 2 RCTs) with 2383 patients were included in this study. Rates of SSI ranged from 0% to 2.3%, whereas CC ranged from 0% to 53%. Antibiotic prophylaxis showed no benefit for both SSI (odds ratio, 1.77; 95% confidence interval, 0.76–4.13) and CC (odds ratio, 0.46; 95% confidence interval, 0.00–45.72). Trial Sequential Analysis demonstrated that further high-quality RCTs are needed. Conclusions Antibiotic prophylaxis for IBBA failed to demonstrate improvements in SSI and CC in this comprehensive review. Current evidence was shown to be of low quality because of heterogeneity and high risk for bias. Further high-quality multicentered RCTs are warranted to fully evaluate the role of antibiotic prophylaxis for IBBA.

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Advances in Etiology and Prevention of Capsular Contracture After Breast Implantation

Li,

Lan,

Zhao

et al. 2024

Aesth Plast Surg

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Capsular contracture (CC) is one of the most common complications of breast implant usage in breast augmentation or reconstruction. The CC approach can cause breast hardening, pain, and varying degrees of deformity, affecting the quality of life of patients. Considerably, it has become one of the most common reasons for frequent surgeries. Nonetheless, the etiology and pathogenesis of CC remain unclear. Moreover, there exist still a lot of uncertainties regarding prevention and treatment measures. In this article, we present discussions on the research status of the etiology, pathogenesis, prevention, and treatment measures of CC. In summary, this study provides a reference for further research on CC and clinical use.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Antibiotic treatment and prophylaxis of periprosthetic infections: Evaluation of 666 consecutive breast implant removals

Cited by 6 publications

References 41 publications

Analysis of pathogen distribution and antimicrobial resistance at infected sites in plastic surgery

Analysis of pathogen distribution and antimicrobial resistance at infected sites in plastic surgery

The Role of Antibiotic Prophylaxis in Primary and Secondary Implant-Based Breast Augmentation

Advances in Etiology and Prevention of Capsular Contracture After Breast Implantation

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