PDF(Pubmed)
Abstract：
BACKGROUND: With the rise in the mastectomy rate, the number of patients who choose to undergo postmastectomy reconstruction has been increasing, and implant-based procedures are the most performed methods for postmastectomy breast reconstruction. Among the possible complications, the most feared is the loss of reconstruction. It can be related to several reasons, but one of the most common is infection of the implant, which can lead to prolonged antibiotic treatment, undesired additional surgical procedures, increased incidence of capsular contracture, and unsatisfactory aesthetics results, with a huge psychological impact on patients.
OBJECTIVE: The primary intent of this study is to analyze the status of infection rates at our institution and evaluate the effectiveness of our prevention protocol since its introduction. Secondly, we compared data of the surgical site infections (SSIs) after implant-based breast reconstruction at Trieste Hospital, where the protocol has been employed since 2020, and in another center, where plastic surgeons of our team are involved, with different prevention procedures.
RESULTS: We enrolled 396 female patients, who underwent implant-based breast reconstruction, using definitive mammary implants or breast tissue expanders, with or without ADM (acellular dermal matrix), both for breast cancer and risk-reducing surgery in BRCA1/2 patients. Patients treated at the Hospital of Trieste, with the use of the prevention protocol, were considered the experimental group (group 1), while patients treated in Gorizia by the same breast team with standardized best-practice rules, but without the use of the prevention protocol, were considered the control group (group 2). Infected patients were 5 in the first group (1.7%) and 8 in the second one (7.9%), with a global infection rate of 3.2%.
CONCLUSIONS: After the introduction of our prevention protocol, we faced a lower incidence of infection after breast surgery with implants or tissue expanders.
OBJECTIVE: The primary intent of this study is to analyze the status of infection rates at our institution and evaluate the effectiveness of our prevention protocol since its introduction. Secondly, we compared data of the surgical site infections (SSIs) after implant-based breast reconstruction at Trieste Hospital, where the protocol has been employed since 2020, and in another center, where plastic surgeons of our team are involved, with different prevention procedures.
RESULTS: We enrolled 396 female patients, who underwent implant-based breast reconstruction, using definitive mammary implants or breast tissue expanders, with or without ADM (acellular dermal matrix), both for breast cancer and risk-reducing surgery in BRCA1/2 patients. Patients treated at the Hospital of Trieste, with the use of the prevention protocol, were considered the experimental group (group 1), while patients treated in Gorizia by the same breast team with standardized best-practice rules, but without the use of the prevention protocol, were considered the control group (group 2). Infected patients were 5 in the first group (1.7%) and 8 in the second one (7.9%), with a global infection rate of 3.2%.
CONCLUSIONS: After the introduction of our prevention protocol, we faced a lower incidence of infection after breast surgery with implants or tissue expanders.
摘要：
背景：随着乳房切除术率的上升，选择接受乳房切除术后重建的患者数量一直在增加，和基于植入物的手术是乳房切除术后乳房重建最有效的方法。在可能的并发症中，最可怕的是重建的损失。这可能与几个原因有关，但最常见的是植入物感染，这可能导致长期的抗生素治疗，不希望的额外外科手术，包膜挛缩的发生率增加，和不令人满意的美学结果，对患者产生巨大的心理影响。
目的：这项研究的主要目的是分析我们机构的感染率状况，并评估我们的预防方案自引入以来的有效性。其次,我们比较了的里雅斯特医院基于植入物的乳房重建后手术部位感染（SSIs）的数据，该协议自2020年以来一直在使用，在另一个中心，我们团队的整形外科医生参与其中，不同的预防程序。
结果：我们招募了396名女性患者，他接受了基于植入物的乳房重建，使用明确的乳房植入物或乳房组织扩张器，有或没有ADM（无细胞真皮基质），BRCA1/2患者的乳腺癌和降低风险的手术。在的里雅斯特医院接受治疗的患者，通过使用预防协议，被认为是实验组（第1组），而在Gorizia由同一乳腺团队以标准化的最佳实践规则治疗的患者，但是没有使用预防方案，被认为是对照组（第2组）。第一组感染患者5例（1.7%），第二组患者8例（7.9%），全球感染率为3.2%。
结论：在引入我们的预防方案后，我们在使用植入物或组织扩张器的乳房手术后面临较低的感染发生率.
目的：这项研究的主要目的是分析我们机构的感染率状况，并评估我们的预防方案自引入以来的有效性。其次,我们比较了的里雅斯特医院基于植入物的乳房重建后手术部位感染（SSIs）的数据，该协议自2020年以来一直在使用，在另一个中心，我们团队的整形外科医生参与其中，不同的预防程序。
结果：我们招募了396名女性患者，他接受了基于植入物的乳房重建，使用明确的乳房植入物或乳房组织扩张器，有或没有ADM（无细胞真皮基质），BRCA1/2患者的乳腺癌和降低风险的手术。在的里雅斯特医院接受治疗的患者，通过使用预防协议，被认为是实验组（第1组），而在Gorizia由同一乳腺团队以标准化的最佳实践规则治疗的患者，但是没有使用预防方案，被认为是对照组（第2组）。第一组感染患者5例（1.7%），第二组患者8例（7.9%），全球感染率为3.2%。
结论：在引入我们的预防方案后，我们在使用植入物或组织扩张器的乳房手术后面临较低的感染发生率.
