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Defining Infection in Breast Reconstruction: A Literature Review

Shayda Mirhaidari Vitali Azouz Douglas Wagner
Summa Health System
2017-02-14

Presenter: Shayda Mirhaidari

Affidavit:
I certify that the submitted abstract is the original work of the above authors/residents.

Director Name: Douglas Wagner

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)

Abstract:

Background:
The incidence of infection after immediate breast reconstruction with prosthesis varies from 1-40%. This variance may be explained by the literature's lack of consensus on what constitutes an infection. The purpose of this study was to review the prevalence of infection and how it is defined in studies involving prosthetic-based immediate breast reconstruction. It is necessary to establish a clear definition of infection in order to standardize the reporting of complications in the literature.

Methods:
A comprehensive literature review was performed to identify infection rates among implant/tissue expander-based immediate breast reconstructions performed between 1990-2017. The authors performed a PubMed search using the keywords "immediate breast reconstruction" matched with "infection" and "tissue expanders" or "implant". The definition of infection was recorded if provided by the article. Review articles, case reports, and meta-analyses were excluded from the study.

Results:
Our initial search provided 202 articles. Of the articles that met our inclusion criteria, the majority of the published literature failed to define infection when reporting complication rates. Those studies that characterized infection had highly variable definitions. While some authors chose to define infection based on the CDC guidelines, others used more subjective findings such as redness and swelling.

Conclusions:
Currently, there is no consensus on the definition of infection after immediate breast reconstruction. We propose a universal definition of infection that allows surgeons, clinicians, and researchers to make comparisons between studies in order to accurately capture the incidence of complications after immediate breast reconstruction.

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