A mastectomy is an emotional, life-changing ordeal. An infection and subsequent delay in
reconstructive surgery decreases a patient’s quality of life by delaying recovery and the
resumption of pre-surgical activities. The highest risk for TE-related infections occurs at the time of
surgery and while the drain remains in place allowing portals for microbial colonization (about two weeks
post-operatively).
Infection Post-Mastectomy
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The rate of infection post-mastectomy with the use of a tissue expander (TE) is 2.4 to
24%. Estimated mean is 12-14%*.
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Once an implant becomes infected, the patient requires increased hospitalization
and approximately 2 weeks of IV and/or oral antimicrobials. The TE is removed, leading to a possible
delay of lifesaving chemo or radiation therapy, along with a more complex reconstruction in the future.
The preventive measures used to decrease the rate of TE infections are:
a)
systemic perioperative antimicrobial agents;
b) perioperative immersion of the implant or
irrigation of the surgical pocket with an antimicrobial solution prior to insertion of the device; or
c) immediate postoperative oral antimicrobials.
Except for (a), all of the other preventive
modalities are of debatable use.