Optimizing Breast-Pocket Irrigation: The Post-Betadine Era

Adams, William P.; Conner, William C.; Barton, Fritz E.; Rohrich, Rod J.

doi:10.1097/00006534-200105000-00049

Cited by 115 publications

(70 citation statements)

References 9 publications

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“…An accurate surgery should be pursued, reducing bleedings and tissues devascularization, through careful atraumatic dissections with proper surgical tools. We advise to perform implant pocket irrigation with triple antibiotic solution as suggested by Adams and colleagues (39)(40)(41) or 500 cc of saline solution with one vial of amikacine (for each breast). We also advice to fit the implant pocket with saline solution wet gauzes for five minutes to remove any residual dust inside the pocket, then washing the skin with antibacterial solution and remove the gauzes.…”

Section: Basic Rules To Minimize Contamination In Aesthetic Breast Aumentioning

confidence: 99%

How to prevent complications in breast augmentation

Nava¹,

Rancati²,

Angrigiani³

et al. 2017

Gland Surg.

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Abstract:No high-level evidences about the best technique or the best implant to use for obtaining the best outcomes in aesthetic breast augmentation, with low complications and re-interventions rates exist from available literature. In this paper we present the actual best evidence about the etiopathogenesis of main complications in aesthetic breast augmentation, identifying some basic rules to follow in order to reduce complication rates in our daily activity, minimizing re-interventions, obtaining long lasting results and high women's satisfaction levels.

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Section: Basic Rules To Minimize Contamination In Aesthetic Breast Aumentioning

confidence: 99%

How to prevent complications in breast augmentation

Nava¹,

Rancati²,

Angrigiani³

et al. 2017

Gland Surg.

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“…Our solution combined the recommendations by Adams et al 9 for antibiotics with the suggestions by Burkhardt and Eades 7 and Wiener 8 for povidone-iodine. However, both our antibiotics and our povidone-iodine solutions had a higher concentration than the ones reported in the studies by Adams et al 9,37,38 In our solution, bacitracin was not used due to limited availability in Finland. We also used cefuroxime instead of cefazolin for the same reason.…”

Section: Discussionmentioning

confidence: 72%

Povidone-Iodine Combined With Antibiotic Topical Irrigation to Reduce Capsular Contracture in Cosmetic Breast Augmentation

Giordano¹,

Peltoniemi²,

Lilius³

et al. 2013

Aesthetic Surgery Journal

115

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“…A recent systematic review underlines the fact that antibiotic prophylaxis in reconstructive surgery lowers the risk of surgical site infection; this study also emphasized that continuing prophylaxis beyond 24 hours after surgery [25] may not be useful, which has already been suggested by the CDC. Some studies [26] suggest the use of medicated implants to achieve reduction of capsular contracture, but further prospective studies are needed before recommending a widespread use of medicated implants that may increase the selection of antibiotic-resistant bacterial strains.…”

Section: Antibiotic Prophylaxismentioning

confidence: 99%

Infections in breast implants: a review with a focus on developing countries

Rubino

Brongo

Pagliara

et al. 2014

J Infect Dev Ctries

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The risk of surgical site infection is always present in surgery; the use of prosthetic materials is linked to an increased possibility of infection. Breast augmentation and breast reconstruction with implants are gaining popularity in developing countries. Implant infection is the main complication related to breast aesthetic and reconstructive surgery. In the present paper, we reviewed the current microbiological knowledge about implant infections, with particular attention to risk factors, diagnosis, clinical management, and antibiotic prophylaxis, focusing on reports from developing countries. After breast aesthetic surgery, up to 2.9% of patients develop a surgical site infection, with an incidence of 1.7% for acute infections and 0.8% for late infections. The rate of surgical site infection after post-mastectomy breast reconstruction is usually higher, ranging from 1% to 53%. The clinical features are not constant, and bacterial culture with antibiogram is the gold standard for diagnosis and for identification of antibiotic resistance. While waiting for culture results, empiric therapy with vancomycin and extendedspectrum penicillins or cephalosporins is recommended. Some patients require removal of the infected prosthesis. The main methods to bring down the risk of infection are strict asepsis protocol, preoperative antibiotic prophylaxis, and irrigation of the surgical pocket and implant with an antibiotic solution.Key words: breast implant infections; acute infections; late infections; fungal infections; rare infections. EpidemiologyImplant infection is the main complication related to breast aesthetic and reconstructive surgery [1]. After breast aesthetic augmentation, up to 2.9% of women are affected by infection [2], with an incidence of 1.7% for acute infections versus an incidence of 0.8% for late infections, as confirmed by retrospective cohort studies with long-term follow-ups [1]. In developing countries, this problem is even more prevalent; surgery has a 50% rate of possible complications, of which infection is the main complication [3]. The rate of surgical site infection after post-mastectomy breast reconstruction is usually higher, ranging from 1% to 53% [4,5]. In breast reconstruction, a higher rate of infection was reported with expander implants compared to reconstruction with autologous tissue such as latissimus dorsi flaps [6]. The highest rates were found in women undergoing immediate reconstruction [4]. The reported number of infections after mammary augmentation and reconstruction is lower than the real incidence, because of the lack of a surveillance network of patients based on long-time follow-ups. The economic commitment for management of implant infections is significant. Kirkland et al. [7] reported an increase of hospital permanence for surgical site infection of 6.5 days, with related health care costs. In the United States, health care costs for surgical site infection after breast surgery were estimated to be about $4,091 [7], or $574 in the outpatient setting [9]...

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Optimizing Breast-Pocket Irrigation: The Post-Betadine Era

Cited by 115 publications

References 9 publications

How to prevent complications in breast augmentation

How to prevent complications in breast augmentation

Povidone-Iodine Combined With Antibiotic Topical Irrigation to Reduce Capsular Contracture in Cosmetic Breast Augmentation

Infections in breast implants: a review with a focus on developing countries

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