Plastic Surgery Research Council
Members Only  |  Contact  |  PSRC on Facebook
PSRC 60th Annual Meeting
Program and Abstracts

Back to 2015 Annual Meeting Posters


Infectious Loss of Tissue Expanders in Breast Reconstruction: Are We Treating the Right Organisms?"
Gabriel Klein, M.D.1, Bret T. Phillips, MD, MBA2, Wilmena Landford, B.S.1, A. Laurie Shroyer, PhD1, Duc Bui, M.D.1, Alex Dagum, M.D1, Sami Khan, M.D.1.
1Stony Brook University Hospital, Stony Brook, NY, USA, 2Duke University, Division of Plastic, Maxillofacial and Oral Surgery, Durham, NC, USA.

PURPOSE:
Postoperative infections following tissue expander based breast reconstruction pose a serious threat to the post mastectomy reconstructive process, with an incidence of 2-24%. Many studies have looked into risk factors for these infections, although very few have focused on the causative organisms. The purpose of this study was to investigate the bacterial flora associated with tissue expander infections in breast reconstruction at our institution
METHODS:
A retrospective analysis of all patients from January 2010 till April 2013 from our institution was conducted. A total of 56 tissue expander infections were identified in 49 patients. The medical records were studied for demographic information, medical history, operative technique, postoperative course, and culture results.
RESULTS:
A total of 41.1% of the cultures grew skin flora, while 28.6% grew gram negative species. Of all cultures the two most common organisms grown were staph aureus (17.9%) and staph epidermidis (14.3%). Of the gram negative species, pseudomonas grew out the most frequently, and was also the third most frequent of all organisms, causing 10.9% of all infections. Of note, 17 of our samples (30.4%) failed to grow an organism in culture
CONCLUSION:
With such a high rate of infection, adequate perioperative prophylaxis is a must in breast reconstructive. This issue that arises from our paper centers on the organisms being treated. While the majority of our infections were secondary to skin flora, a significant proportion were caused by gram negative species. Given these results we feel the perioperative prophylaxis regimens as well as all antibiotic given for postoperative infections should be reconsidered.
Culture Results
BacteriaNumber (%)
Staphylococcus Aureus10 (17.9)
Staphylococcus Epidermidis8 (14.3)
Streptococcus3 (5.4)
MRSA2 (3.6)
Pseudomonas6 (10.7)
Serratia3 (5.4)
Proteus1 (1.8)
E. Coli1 (1.8)
Polymicrobial (Gram negatives)5 (8.9)


Back to 2015 Annual Meeting Posters