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Absorbable Antibiotic Bead Prophylaxis for Implant-Based Breast Reconstruction: A Single-Institution Experience
Casey Zhang, BS; Shirley Liu, MS; Hilary Liu, BS; James Fisher, MD PhD; Carolyn De La Cruz, MD; Michael L. Gimbel, MD; Vu T. Nguyen, MD; Brodie Parent, MD MS
University of Pittsburgh Medical Center
2024-01-13
Presenter: Casey Zhang
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. I certify that this work entirely represents the original work of the resident or medical student.
Director Name: Vu Nguyen
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Introduction:
Surgical site infection remains a serious complication of implant-based reconstruction (IBR). Prophylactic use of bioabsorbable antibiotic-coated beads has demonstrated potential in reducing infections. This preliminary study aims to describe a single institution's experience with absorbable antibiotic beads for preventing infection in IBR.
Methods:
A retrospective cohort study was performed of all patients who underwent IBR between January 2021- October 2023. Patients who met one or more high-risk criteria for infection including BMI > 30, active or prior smoking, type 2 diabetes mellitus, and history of radiation therapy, received absorbable antibiotic beads mixed with vancomycin and gentamicin. The primary outcome was development of periprosthetic infection. Multivariable regression was performed to control for known risk factors associated with infection.
Results:
246 patients were included in the study. 15 (6.1%) patients received antibiotic beads during the first-stage expander-based reconstruction. No difference was detected in infection rate between patients who received antibiotic beads at the time of primary reconstruction compared to the standard of care (33.3% vs. 22.0%, p=.309). After controlling for BMI, diabetes, history of radiation, and smoking status, antibiotic beads were not associated with infection (OR 1.24, CI 0.37-4.13, p=.721). The salvage rate of infections with antibiotic beads was 87.5% (7/8).
Conclusion:
This study presents preliminary results of our institution's experience using antibiotic beads for infection prophylaxis in high-risk patients undergoing breast reconstruction and salvage of infected breast implants. Additional prospective studies are currently ongoing, and are needed help to elucidate safety and efficacy.
