title: Contributing variables to post mastectomy tissue expander infection.
abstract: Tissue expander breast reconstruction is a common post mastectomy breast procedure performed by plastic surgeons. The purpose of this study was to define the incidence of breast reconstruction prosthetic infection, relate patient characteristics with increased rate of infection, and analyze the influence of postoperative complications to expander/implant infection. A retrospective, single-institution chart review of 195 women with post mastectomy tissue expander/implant reconstructions performed from 2006 through 2008 was conducted. Total periprosthetic infection rate was calculated. Patient factors, operative technique, and noninfectious complications were analyzed and related to increased periprosthetic infection rate. A binary logistic regression model was fitted using periprosthetic infection as the dependent variable and 12 patient characteristics as independent variables, followed by a step-wise model for best fit with a limited number of independent variables. The overall periprosthetic infection rate per patient over the 2 year period was 5.1%. The incidence of periprosthetic infection per reconstructed breast was 3.2%. Odds ratio estimates indicated that the presence of cellulitis increased the odds of periprosthetic infection more than 200 times (p = <0.0001), and inpatient procedures increased the odds 16 times (p = 0.02). Other variables (i.e., age > 65, DM, flap necrosis, smoking, dehiscence, AlloDerm, etc) failed to reach statistical significance (p > 0.05). Postoperative breast cellulitis and inpatient status appear to be significant risk factors for increased periprosthetic infection. No significant increase in periprosthetic infection rate was noted with other variables in this model.
authors.affiliation: Division of Plastic Surgery, Department of Surgery, University of Nevada School of Medicine, Las Vegas, Nevada 89102-2227, USA.
authors.forename: Mark M
authors.initials: MM
authors.lastname: Leyngold
authors.forename: Ross L
authors.initials: RL
authors.lastname: Stutman
authors.forename: Kayvan T
authors.initials: KT
authors.lastname: Khiabani
authors.forename: Himansu
authors.initials: H
authors.lastname: Shah
authors.forename: Elvis
authors.initials: E
authors.lastname: Fong
authors.forename: Chih-Hsiang
authors.initials: CH
authors.lastname: Ho
authors.forename: William A
authors.initials: WA
authors.lastname: Zamboni
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000601:surgery; D005260:Female; D006801:Humans; D016015:Logistic Models; D016462:Mammaplasty / Q000009:adverse effects* / Q000379:methods; D008408:Mastectomy / Q000009:adverse effects; D008875:Middle Aged; D009336:Necrosis; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D016459:Prosthesis-Related Infections / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012907:Smoking; D013524:Surgical Flaps / Q000473:pathology; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology*; D015626:Tissue Expansion / Q000009:adverse effects* / Q000379:methods; D015625:Tissue Expansion Devices