Analysis of risk factors related to periprosthetic infection after breast augmentation_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LI Min ,  TANG Shengjian

Plastic Surgery Hospital of Weifang Medical College, Weifang Shandong, 261041, P.R.China;

Corresponding?author：

TANG Shengjian, Email: tsj3676@163.com

Keywords：

Breast augmentation; periprosthetic infection; complication; risk factor

DOI：

10.7507/1002-1892.201901093

Video：

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Objective To explore the risk factors related to periprosthetic infection after breast augmentation, and to provide a basis for reducing the risk of postoperative infection. Methods A total of 1 056 female patients who underwent breast augmentation between January 2010 and January 2018 were analyzed retrospectively. The patients were 20 to 44 years old (mean, 31.6 years). The body mass index (BMI) was 19.0-31.1 kg/m², with an average of 24.47 kg/m². According to the periprosthetic infection standard of the United States Centers for Disease Control and Prevention (CDC), the patients were divided into infection group and non-infection group. Age, BMI, diabetes, previous history of immunosuppression, history of smoking, previous history of breast surgery, previous history of mastitis, combined with active dermatitis, surgical approach, the type and shape of breast prosthesis, implant in the different layers, combined with mastopexy, operation time, postoperative antibiotic time, postoperative breast crash, and postoperative potential infection surgery were analyzed by univariate analysis. The influencing factors of prosthetic infection were screened by logistic regression. Results Periprosthetic infection occurred in 60 cases after operation, and the infection rate was 5.68%. Among them, 11 cases were acute infection, 33 cases were subacute infection, 16 cases were delayed infection, and 20 cases were positive in bacterial culture. Postoperative breast crash occurred in 114 cases. Univariate analysis showed that diabetes, previous history of immunosuppression, history of smoking, previous history of mastitis, postoperative breast crash, postoperative potential infection surgery, and combined with breast suspension were the influencing factors of postoperative periprosthetic infection (P<0.05). Multivariate analysis showed that diabetes, history of smoking, and postoperative breast crash were the risk factors of periprosthetic infection (P<0.05). Conclusion Diabetes, smoking, and postoperative breast crash are the risk factors of periprosthetic infection after breast augmentation.

Citation： LI Min, TANG Shengjian. Analysis of risk factors related to periprosthetic infection after breast augmentation. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(7): 889-893. doi: 10.7507/1002-1892.201901093 Copy

1.	楊艷清, 郭能強, 孫家明, 等. 筋膜下隆乳術與乳腺后間隙隆乳術的臨床效果和并發癥比較. 中華整形外科雜志, 2013, 29(1): 12-14.
2.	Washer LL, Gutowski K. Breast implant infections. Infect Dis Clin North Am, 2012, 26(1): 111-125.
3.	Momoh AO, Ahmed R, Kelley BP, et al. A systematic review of complications of implant-based breast reconstruction with prereconstruction and postreconstruction radiotherapy. Ann Surg Oncol, 2014, 21(1): 118-124.
4.	Lalani T. Breast implant infections: An update. Infect Dis Clin North Am, 2018, 32(4): 877-884.
5.	Barr SP, Topps AR, Barnes NL, et al. Infection prevention in breast implant surgery-A review of the surgical evidence, guidelines and a checklist. Eur J Surg Oncol, 2016, 42(2): 591-603.
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8.	Franchelli S, Pesce M, Baldelli I, et al. Analysis of clinical management of infected breast implants and of factors associated to successful breast pocket salvage in infections occurring after breast reconstruction. Int J Infect Dis, 2018, 71: 67-72.
9.	Olsen MA, Lefta M, Dietz JR, et al. Risk factors for surgical site infection after major breast operation. J Am Coll Surg, 2008, 207(3): 326-335.
10.	劉海燕. 吸煙對圍手術期患者的危害. 中國藥物與臨床, 2012, 12(5): 632-633.
11.	Rubino C, Brongo S, Pagliara D, et al. Infections in breast implants: a review with a focus on developing countries. J Infect Dev Ctries, 2014, 8(9): 1089-1095.
12.	闕纖灃, 徐秀群, 何紅, 等. 人工髖關節置換術患者假體周圍感染相關因素及干預措施分析. 中華醫院感染學雜志, 2018, 28(4): 555-558.
13.	趙新華, 袁航, 錢金黔, 等. 后路椎體間融合術治療復發性腰椎間盤突出癥圍手術期并發癥及其危險因素. 中華骨科雜志, 2016, 36(17): 1121-1125.
14.	Tobin G, Shaw RC, Goodpasture HC. Toxic shock syndrome following breast and nasal surgery. Plast Reconstr Surg, 1987, 80(1): 111-114.
15.	孫晶晶, 欒杰, 穆大力, 等. 中國女性假體隆乳術不同切口瘢痕的前瞻性對比研究. 中華整形外科雜志, 2018, 34(2): 101-109.
16.	陳偉華, 王琳, 呂遠東, 等. 乳房假體放置層次的臨床進展. 中華醫學美學美容雜志, 2006, 12(6): 382-384.
17.	胡瓊華, 祁佐良, 王煒. 隆乳相關問題的研究進展. 中華醫學美學美容雜志, 2001, 7(4): 216-218.
18.	劉杰偉, 張偉, 祝葆華. 隆乳假體及置入層次影響包膜攣縮形成的臨床回顧研究. 中國美容醫學, 2016, 25(11): 11-14.
19.	宋興桂, 李昕, 宋俊雷, 等. 保留假體清創術治療人工關節置換術后假體周圍感染的臨床研究. 中國修復重建外科雜志, 2018, 32(6): 685-693.
20.	房體義. 全髖關節置換后假體周圍感染的病原菌分布及危險因素分析. 中國保健營養, 2017, 27(24): 121.
21.	中華醫學會整形外科學分會乳房專業學組. 硅膠乳房假體隆乳術臨床技術指南. 中華整形外科雜志, 2013, 29(1): 1-4.
22.	Leaper D, Burman-Roy S, Palanca A, et al. Prevention and treatment of surgical site infection: summary of NICE guidance. BMJ, 2008, 337(7677): 1049-1051.
23.	Phillips BT, Bishawi M, Dagum AB, et al. A systematic review of infection rates and associated antibiotic duration in acellular dermal matrix breast reconstruction. Eplasty, 2014, 14: e42.

1. 楊艷清, 郭能強, 孫家明, 等. 筋膜下隆乳術與乳腺后間隙隆乳術的臨床效果和并發癥比較. 中華整形外科雜志, 2013, 29(1): 12-14.
2. Washer LL, Gutowski K. Breast implant infections. Infect Dis Clin North Am, 2012, 26(1): 111-125.
3. Momoh AO, Ahmed R, Kelley BP, et al. A systematic review of complications of implant-based breast reconstruction with prereconstruction and postreconstruction radiotherapy. Ann Surg Oncol, 2014, 21(1): 118-124.
4. Lalani T. Breast implant infections: An update. Infect Dis Clin North Am, 2018, 32(4): 877-884.
5. Barr SP, Topps AR, Barnes NL, et al. Infection prevention in breast implant surgery-A review of the surgical evidence, guidelines and a checklist. Eur J Surg Oncol, 2016, 42(2): 591-603.
6. 王煒. 整形外科學. 杭州: 浙江科學技術出版社, 1999: 9.
7. Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control, 2008, 36(5): 309-332.
8. Franchelli S, Pesce M, Baldelli I, et al. Analysis of clinical management of infected breast implants and of factors associated to successful breast pocket salvage in infections occurring after breast reconstruction. Int J Infect Dis, 2018, 71: 67-72.
9. Olsen MA, Lefta M, Dietz JR, et al. Risk factors for surgical site infection after major breast operation. J Am Coll Surg, 2008, 207(3): 326-335.
10. 劉海燕. 吸煙對圍手術期患者的危害. 中國藥物與臨床, 2012, 12(5): 632-633.
11. Rubino C, Brongo S, Pagliara D, et al. Infections in breast implants: a review with a focus on developing countries. J Infect Dev Ctries, 2014, 8(9): 1089-1095.
12. 闕纖灃, 徐秀群, 何紅, 等. 人工髖關節置換術患者假體周圍感染相關因素及干預措施分析. 中華醫院感染學雜志, 2018, 28(4): 555-558.
13. 趙新華, 袁航, 錢金黔, 等. 后路椎體間融合術治療復發性腰椎間盤突出癥圍手術期并發癥及其危險因素. 中華骨科雜志, 2016, 36(17): 1121-1125.
14. Tobin G, Shaw RC, Goodpasture HC. Toxic shock syndrome following breast and nasal surgery. Plast Reconstr Surg, 1987, 80(1): 111-114.
15. 孫晶晶, 欒杰, 穆大力, 等. 中國女性假體隆乳術不同切口瘢痕的前瞻性對比研究. 中華整形外科雜志, 2018, 34(2): 101-109.
16. 陳偉華, 王琳, 呂遠東, 等. 乳房假體放置層次的臨床進展. 中華醫學美學美容雜志, 2006, 12(6): 382-384.
17. 胡瓊華, 祁佐良, 王煒. 隆乳相關問題的研究進展. 中華醫學美學美容雜志, 2001, 7(4): 216-218.
18. 劉杰偉, 張偉, 祝葆華. 隆乳假體及置入層次影響包膜攣縮形成的臨床回顧研究. 中國美容醫學, 2016, 25(11): 11-14.
19. 宋興桂, 李昕, 宋俊雷, 等. 保留假體清創術治療人工關節置換術后假體周圍感染的臨床研究. 中國修復重建外科雜志, 2018, 32(6): 685-693.
20. 房體義. 全髖關節置換后假體周圍感染的病原菌分布及危險因素分析. 中國保健營養, 2017, 27(24): 121.
21. 中華醫學會整形外科學分會乳房專業學組. 硅膠乳房假體隆乳術臨床技術指南. 中華整形外科雜志, 2013, 29(1): 1-4.
22. Leaper D, Burman-Roy S, Palanca A, et al. Prevention and treatment of surgical site infection: summary of NICE guidance. BMJ, 2008, 337(7677): 1049-1051.
23. Phillips BT, Bishawi M, Dagum AB, et al. A systematic review of infection rates and associated antibiotic duration in acellular dermal matrix breast reconstruction. Eplasty, 2014, 14: e42.

Chinese Journal of Reparative and Reconstructive Surgery

Analysis of risk factors related to periprosthetic infection after breast augmentation

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