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Implant Based Breast Reconstruction Outcomes Using Oxychlorosene for Pocket Irrigation
Ravinder Bamba, Phu Tran, Jenny Lin, William DeBrock, , Aladdin H. Hassanein
Indiana University
2020-02-14
Presenter: Ravinder Bamba
Affidavit:
Yes
Director Name: William Wooden
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Purpose: Breast pocket irrigation with antiseptic solutions is performed to reduce contamination with breast implants. The optimal antiseptic irrigation solution and the efficacy of individual practices is unclear. Sodium oxychlorosene (0.4%) is frequently used at our institution. The purpose of our study was to compare the outcomes of sodium oxychlorosene irrigation with other surgical irrigations in implant-based reconstruction.
Methods: We retrospectively reviewed patients who underwent implant-based reconstruction after mastectomy (2013-2018) at our institution. Predictive variables were demographic data, comorbidities, and irrigant used. Outcomes variables were surgical site infection (90 days) and device removal.
Results: The study included 226 patients (375 implants) who underwent immediate breast reconstructions. Tissue expander reconstruction (88.5%, n=200) or direct-to-implant (11.5%) was performed . In the oxychlorosene irrigation group (n=117), 2.6% had cellulitis requiring intravenous antibiotics and 4.1% (n=8) had an infection requiring device removal. The triple antibiotic group (n=48) had cellulitis requiring intravenous antibiotics (3.9%) and had an infection requiring implant removal (3.9%). In the bacitracin irrigation group (n=61), 11.7% had cellulitis requiring intravenous antibiotics and 9.7% had an infection requiring device removal. Oxychlorosene and triple antibiotic solution had lower infection rates compared to bacitracin irrigation (p<0.05).
Conclusions: Oxychlorosene and triple antibiotic solutions have similar surgical site infection rates which are superior to bacitracin. Oxychlorosene is bactericidal with a mechanism of action of oxidation and hypochlorination. This may translate to a greater potential against biofilm compared to triple antibiotic solution. Further studies are merited to as evaluate effect on biofilm production.
