title: The Mulcahy Salvage: Past and Present Innovations.
abstract: BACKGROUND
  Inflatable penile implants are a mainstay for the surgical correction of erectile dysfunction. For the last 40 years they have provided reliable outcomes with durable patient satisfaction. Infection of the implant continues to remain the primary surgical concern, despite the advent of antibiotic-coated devices and improved skin preparation solutions.
  
  
  METHODS
  In this article, we review and evaluate the published literature for important contributions surrounding the various salvage techniques and washout strategies. In addition, the role of biofilm in prosthetic infection will be discussed.
  
  
  RESULTS
  First described by Mulcahy for instances of device infection, the salvage or rescue procedure was established to avoid complete removal and staged replacement. This approach, with its avoidance of difficult revision surgery, penile shortening and patient discomfort, has produced success as high as 84%.
  
  
  CONCLUSIONS
  Mulcahy's innovative approach at salvage or rescue reimplantation has proven to be a highly successful approach to this difficult surgical problem. Without question, the report of the long-term results of his salvage patients has directly influenced a generation of prosthetic surgeons.
authors.affiliation: Department of Urology, Indiana University, Indianapolis, IN, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Mellon
authors.affiliation: Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA.
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Broghammer
authors.affiliation: Urology, Regional Urology, Shreveport, LA, USA.
authors.forename: Gerard D
authors.initials: GD
authors.lastname: Henry
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004866:Equipment Contamination / Q000517:prevention & control; D007172:Erectile Dysfunction / Q000503:physiopathology / Q000601:surgery*; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D015917:Penile Prosthesis / Q000009:adverse effects / Q000382:microbiology* / Q000706:statistics & numerical data; D010413:Penis / Q000382:microbiology / Q000601:surgery*; D012086:Reoperation; D016879:Salvage Therapy / Q000379:methods* / Q000639:trends; D013530:Surgical Wound Infection / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents
keywords: Biofilm; Infection; Penile Prosthesis; Penis; Salvage; Surgery