Is Instillational Topical Negative Pressure Wound Therapy in Peri-Prosthetic Infections of the Breast Effective? A Pilot Study

Abstract

Peri-prosthetic breast infections pose a risk of severe complications after breast implant surgery. The need to remove the breast implant, control the infection and perform additional surgical procedures are the consequences. Reimplantation of an alloplastic implant is only appropriate after an infection-free interval. In this retrospective cohort study, we investigated the effectiveness of negative pressure wound treatment with instillation and dwell time (NPWTi-d) on peri-prosthetic breast infections in combination with implant removal and antibiotic therapy. Twelve patients treated with NPWTi-d due to breast implant infection were included in the study. The bacterial burden was analyzed using wound swabs before and after NPWTi-d. Additionally, laboratory values were determined before NPWTi-d and immediately before wound closure. A total of 13 peri-prosthetic breast infections in 12 patients were treated using implant removal and NPWTi-d. In 76.9% (n = 10) of the cases, the patients had undergone alloplastic breast reconstruction following cancer-related mastectomy, whereas 23.1% (n = 3) of the patients had undergone breast augmentation for cosmetic reasons. The bacterial burden in the breast pocket decreased statistically significant after implant removal and NPWTi-d. No shift from Gram-positive to Gram-negative bacteria was observed. Inflammatory markers rapidly decreased following treatment. NPWTi-d had a positive impact on the healing process after peri-prosthetic breast infections, leading to a decrease in bacterial burden within the wounds and contributing to uneventful healing. Therefore, secondary reimplantation of breast prostheses might be positively influenced when compared to conventional implant removal and simple secondary closure. Further studies are required to conclusively establish the beneficial long-term effects of using NPWTi-d for the treatment of peri-prosthetic breast infections.

Analysis of laboratory markers in body contouring procedures after bariatric surgery does not indicate particular risks for perioperative complications

“…Bariatric surgical approaches can cause or worsen nutrient deficiencies. Nutrient deficiency can lead to various health problems, including weakness, hematoma, and infections (Bal et al 2012 ; Gruener et al 2022 ). The existing guidelines form the basis for recommendations on supplementation and treatment after weight loss surgery (Stroh et al 2017 ).…”

Special Issue “Plastic and Reconstructive Surgery in Personalized Medicine”

“…In detail, Grüner et al describe their experience with topical negative pressure therapy with instillation to cope with infected alloplastic implants in breast surgery and offer a new concept for this clinical issue [ 10 ]. Promny and coworkers discuss their findings concerning the safety of lipotransfer after breast-conserving therapy (BCT) and irradiation in breast cancer patients.…”