Antibiotic implant irrigation and deep infection: A retrospective study of 1508 patients undergoing breast reconstruction with implants
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Antibiotic implant irrigation and deep infection : A retrospective study of 1508 patients undergoing breast reconstruction with implants. / Hemmingsen, Mathilde N; Bennedsen, Anne K; Kullab, Randa B; Weltz, Tim K; Ørholt, Mathias; Norlin, Caroline Barskov; Kalstrup, Julie; Bredgaard, Rikke; Sørensen, Søren J; Bjarnsholt, Thomas; Hölmich, Lisbet R; Damsgaard, Tine E; Vester-Glowinski, Peter; Herly, Mikkel.
In: Plastic and Reconstructive Surgery, 2024.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Antibiotic implant irrigation and deep infection
T2 - A retrospective study of 1508 patients undergoing breast reconstruction with implants
AU - Hemmingsen, Mathilde N
AU - Bennedsen, Anne K
AU - Kullab, Randa B
AU - Weltz, Tim K
AU - Ørholt, Mathias
AU - Norlin, Caroline Barskov
AU - Kalstrup, Julie
AU - Bredgaard, Rikke
AU - Sørensen, Søren J
AU - Bjarnsholt, Thomas
AU - Hölmich, Lisbet R
AU - Damsgaard, Tine E
AU - Vester-Glowinski, Peter
AU - Herly, Mikkel
N1 - Copyright © 2023 by the American Society of Plastic Surgeons.
PY - 2024
Y1 - 2024
N2 - BACKGROUND: Antibiotic implant irrigation is increasingly used to prevent deep infection after implant-based breast reconstruction. However, there is limited evidence of the clinical effect. In this study, we compare the risk of a deep infection in a Danish population of women who either received antibiotic implant irrigation with gentamycin or vancomycin, or no irrigation.METHODS: We retrospectively reviewed consecutive patients undergoing all types of breast reconstruction with implants at Rigshospitalet and Herlev Hospital, Denmark, in 2010-2019. Logistic regression was used to compare the risk of deep infection between no irrigation and irrigation with gentamicin or vancomycin, and to account for the difference in risk between patient subgroups and risk factors.RESULTS: We included 1508 patients who received antibiotic irrigation with gentamicin (500 patients), vancomycin (304 patients) or no irrigation (704 patients). The univariable risk analysis showed a significant decreased risk of deep infection using gentamicin irrigation compared with no irrigation (OR 0.58, p<0.05). However, when adjusting for risk factors for infection, there was no significant decrease in the risk of infection when using gentamicin (OR 0.90, p=0.71) or vancomycin (OR 1.0, p=0.99) compared with the control group.CONCLUSIONS: We found no significant effect of using antibiotic implant irrigation after isolating it from risk factors for deep infection. However, due to the limitations of the study, we cannot conclude that there is no effect of antibiotic implant irrigation. There is a need for a randomized, placebo-controlled trial to investigate the effect, and potential side-effects, of antibiotic implant irrigation.
AB - BACKGROUND: Antibiotic implant irrigation is increasingly used to prevent deep infection after implant-based breast reconstruction. However, there is limited evidence of the clinical effect. In this study, we compare the risk of a deep infection in a Danish population of women who either received antibiotic implant irrigation with gentamycin or vancomycin, or no irrigation.METHODS: We retrospectively reviewed consecutive patients undergoing all types of breast reconstruction with implants at Rigshospitalet and Herlev Hospital, Denmark, in 2010-2019. Logistic regression was used to compare the risk of deep infection between no irrigation and irrigation with gentamicin or vancomycin, and to account for the difference in risk between patient subgroups and risk factors.RESULTS: We included 1508 patients who received antibiotic irrigation with gentamicin (500 patients), vancomycin (304 patients) or no irrigation (704 patients). The univariable risk analysis showed a significant decreased risk of deep infection using gentamicin irrigation compared with no irrigation (OR 0.58, p<0.05). However, when adjusting for risk factors for infection, there was no significant decrease in the risk of infection when using gentamicin (OR 0.90, p=0.71) or vancomycin (OR 1.0, p=0.99) compared with the control group.CONCLUSIONS: We found no significant effect of using antibiotic implant irrigation after isolating it from risk factors for deep infection. However, due to the limitations of the study, we cannot conclude that there is no effect of antibiotic implant irrigation. There is a need for a randomized, placebo-controlled trial to investigate the effect, and potential side-effects, of antibiotic implant irrigation.
U2 - 10.1097/PRS.0000000000010869
DO - 10.1097/PRS.0000000000010869
M3 - Journal article
C2 - 37337318
JO - Plastic and Reconstructive Surgery
JF - Plastic and Reconstructive Surgery
SN - 0032-1052
ER -
ID: 385050831