title: Continuous Postoperative Antibiotic Irrigation via Catheter System Following Immediate Breast Reconstruction.
abstract: Breast reconstruction with implantable devices is now the most common type of technique utilized following mastectomy. Because infections are one of the most common complications for the procedure and currently no one method has been proven to stand above the rest, we designed and implemented a novel technique that employed 24 hours continuous triple-antibiotic irrigation via a catheter-based system. From August 2009 to March 2012, 79 patients underwent tissue expander-based reconstruction from a single plastic surgeon. Forty-five consecutive patients underwent breast reconstructive surgery with implant-based reconstruction alone; the remaining 34 patients underwent breast reconstructive surgery with tissue expansion and closed continuous postoperative antibiotic irrigation. Incidences of infection, seroma, hematoma, and premature explantation were recorded. Both the rate of premature explant (20% vs 2.9%; P = 0.037) and surgical site infections (22.2% vs 5.8%, P = 0.060) decreased. Twenty-four hour continuous antibiotic irrigation is a useful adjunct to tissue expander breast reconstruction.
authors.affiliation: University of Louisville Department of Plastic Surgery, Louisville, Ky.
authors.forename: John Paul
authors.initials: JP
authors.lastname: Tutela
authors.affiliation: University of Louisville Department of Plastic Surgery, Louisville, Ky.
authors.forename: David P
authors.initials: DP
authors.lastname: Duncan
authors.affiliation: University of Louisville Department of Plastic Surgery, Louisville, Ky.
authors.forename: S Sean
authors.initials: SS
authors.lastname: Kelishadi
authors.affiliation: University of Louisville Department of Plastic Surgery, Louisville, Ky.
authors.forename: Saeed
authors.initials: S
authors.lastname: Chowdhry
authors.affiliation: University of Louisville Department of Plastic Surgery, Louisville, Ky.
authors.forename: Travis
authors.initials: T
authors.lastname: Boyd
authors.affiliation: University of Louisville Department of Plastic Surgery, Louisville, Ky.
authors.forename: Jarrod A
authors.initials: JA
authors.lastname: Little
keywords: breast reconstruction; catheter system; continuous antibiotic irrigation; infection; mastectomy