<< Back to the abstract archive
Does Irrigation Solution Influence Surgical Site Infection Rates in Immediate Implant-based Breast Reconstruction?
Matthew A. DePamphilis, Sasha Wood, Katya Remy, William G. Austen Jr., Katherine H. Carruthers
Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, Massachusett
2025-01-16
Presenter: Matthew A. DePamphilis
Affidavit:
NA
Director Name: NA
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background
There is no universally accepted best practice for the type of irrigation agent used during implant-based breast reconstruction. Hypochlorous acid has been proposed as an alternative to traditional formulations due to its robust antimicrobial characteristics with minimal inflammatory properties. This study aims to compare the effect of irrigation formulations on surgical site infection following implant-based breast reconstruction.
Methods
A multicenter retrospective cohort study was conducted on 520 consecutive immediate implant-based breast reconstructions after mastectomy. The primary outcome assessed was surgical site infection requiring either hospitalization for IV antibiotic management or operative wash-out, and explant.
Results
Irrigation with 0.033% hypochlorous acid was performed in 109 (21.0%) breasts, triple antibiotic solution in 68 (13.1%), double antibiotic solution with betadine in 150 (28.8%), double antibiotic solution alone in 101 (19.4%), single antibiotic solution in 56 (10.8%), and betadine solution alone in 36 (6.9%). Hypochlorous acid was associated with significant reduction in surgical site infection compared to single antibiotic solution (1.8% vs 10.8%, p=0.034) and betadine solution alone (1.8% vs 6.9%, p=0.016) but similar to double antibiotic solution alone (1.8% vs 4.9%, p=0.218), double antibiotic solution with betadine (1.8% vs 5.3%, p=0.141), and triple antibiotic (1.8% vs 2.9%, p=0.589).
Conclusion
Irrigation with hypochlorous acid may reduce the risk of surgical site infection in implant-based breast reconstruction while limiting the inflammatory reaction commonly seen with antibiotic irrigation. Knowing this, surgeons may choose to utilize hypochlorous acid during implant-based reconstructive procedures, particularly in patients with a history of antibiotic sensitivity.
