Revisiting Triple Antibiotic Irrigation of Breast Implant Pockets: A Placebo-controlled Single Practice Cohort Study
Background: Capsular contracture is the most common complication following primary augmentation mammoplasty. It remains poorly understood but is attributed to subclinical infection, immunologic response to breast implants, and chronic inflammatory changes caused by the presence of the implants. The...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2013-10-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/Fulltext/2013/10000/Article.2.aspx |
| _version_ | 1818960659584385024 |
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| author | James J. Drinane, BSci Ronald S. Bergman, DO, MD Bryan L. Folkers, DO, FACOS Matthew J. Kortes, MD |
| author_facet | James J. Drinane, BSci Ronald S. Bergman, DO, MD Bryan L. Folkers, DO, FACOS Matthew J. Kortes, MD |
| author_sort | James J. Drinane, BSci |
| collection | DOAJ |
| description | Background: Capsular contracture is the most common complication following primary augmentation mammoplasty. It remains poorly understood but is attributed to subclinical infection, immunologic response to breast implants, and chronic inflammatory changes caused by the presence of the implants. The infectious theory of contracture has lead to the practice of irrigating implant pockets with a triple antibiotic solution. The purpose of this study was to determine if antibiotic irrigation reduced the incidence and severity of capsular contracture compared with saline irrigation.
Methods: A cohort study enrolling all patients having undergone primary augmentation mammoplasty performed by surgeon A and surgeon B between 2011 and 2012 for all women satisfying inclusion and exclusion criteria was conducted. The only difference in surgical technique was the use of antibiotic irrigation by surgeon B. A chi-square test and analysis of variance with predetermined 95% confidence intervals were performed.
Results: Fifty-five patients were operated on. Twenty-eight of surgeon A’s patients were included, ranging in age from 22 to 50 with a mean follow-up time of 1.8 years. Twenty-seven of surgeon B’s patients were included, ranging in age from 22 to 56 with a mean follow-up time of 1.6 years. Rate of capsular contracture was 3.6% (surgeon A) and 3.7% (surgeon B). Chi-square statistic was found to be 0.0014 (P = 0.97) and analysis of variance F value was 1 (P = 0.39).
Conclusions: Triple antibiotic breast irrigation is not associated with a significant reduction in the incidence or severity of capsular contracture compared with sterile saline when high-quality surgical technique is used. |
| first_indexed | 2024-12-20T12:01:03Z |
| format | Article |
| id | doaj.art-3271a2ccdc114311a86678edf8901e39 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-12-20T12:01:03Z |
| publishDate | 2013-10-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-3271a2ccdc114311a86678edf8901e392022-12-21T19:41:31ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742013-10-0117e5510.1097/GOX.0b013e3182aa876001720096-201310000-00002Revisiting Triple Antibiotic Irrigation of Breast Implant Pockets: A Placebo-controlled Single Practice Cohort StudyJames J. Drinane, BSci0Ronald S. Bergman, DO, MD1Bryan L. Folkers, DO, FACOS2Matthew J. Kortes, MD3From the College of Osteopathic Medicine and Surgery, Des Moines University, Des Moines, Iowa;Bergman/Folkers Plastic Surgery, Des Moines, Iowa.From the College of Osteopathic Medicine and Surgery, Des Moines University, Des Moines, Iowa;Bergman/Folkers Plastic Surgery, Des Moines, Iowa.Background: Capsular contracture is the most common complication following primary augmentation mammoplasty. It remains poorly understood but is attributed to subclinical infection, immunologic response to breast implants, and chronic inflammatory changes caused by the presence of the implants. The infectious theory of contracture has lead to the practice of irrigating implant pockets with a triple antibiotic solution. The purpose of this study was to determine if antibiotic irrigation reduced the incidence and severity of capsular contracture compared with saline irrigation. Methods: A cohort study enrolling all patients having undergone primary augmentation mammoplasty performed by surgeon A and surgeon B between 2011 and 2012 for all women satisfying inclusion and exclusion criteria was conducted. The only difference in surgical technique was the use of antibiotic irrigation by surgeon B. A chi-square test and analysis of variance with predetermined 95% confidence intervals were performed. Results: Fifty-five patients were operated on. Twenty-eight of surgeon A’s patients were included, ranging in age from 22 to 50 with a mean follow-up time of 1.8 years. Twenty-seven of surgeon B’s patients were included, ranging in age from 22 to 56 with a mean follow-up time of 1.6 years. Rate of capsular contracture was 3.6% (surgeon A) and 3.7% (surgeon B). Chi-square statistic was found to be 0.0014 (P = 0.97) and analysis of variance F value was 1 (P = 0.39). Conclusions: Triple antibiotic breast irrigation is not associated with a significant reduction in the incidence or severity of capsular contracture compared with sterile saline when high-quality surgical technique is used.http://journals.lww.com/prsgo/Fulltext/2013/10000/Article.2.aspx |
| spellingShingle | James J. Drinane, BSci Ronald S. Bergman, DO, MD Bryan L. Folkers, DO, FACOS Matthew J. Kortes, MD Revisiting Triple Antibiotic Irrigation of Breast Implant Pockets: A Placebo-controlled Single Practice Cohort Study Plastic and Reconstructive Surgery, Global Open |
| title | Revisiting Triple Antibiotic Irrigation of Breast Implant Pockets: A Placebo-controlled Single Practice Cohort Study |
| title_full | Revisiting Triple Antibiotic Irrigation of Breast Implant Pockets: A Placebo-controlled Single Practice Cohort Study |
| title_fullStr | Revisiting Triple Antibiotic Irrigation of Breast Implant Pockets: A Placebo-controlled Single Practice Cohort Study |
| title_full_unstemmed | Revisiting Triple Antibiotic Irrigation of Breast Implant Pockets: A Placebo-controlled Single Practice Cohort Study |
| title_short | Revisiting Triple Antibiotic Irrigation of Breast Implant Pockets: A Placebo-controlled Single Practice Cohort Study |
| title_sort | revisiting triple antibiotic irrigation of breast implant pockets a placebo controlled single practice cohort study |
| url | http://journals.lww.com/prsgo/Fulltext/2013/10000/Article.2.aspx |
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