Total capsulectomy and NPWT for management of a Mycobacterium abscessus breast implant infection unresponsive to antimicrobial therapy: a case report and literature review.

Abstract

Background: Nontuberculous mycobacteria (NTM) periprosthetic infections after breast augmentation procedures are increasingly common worldwide and should raise suspicion after empirical antimicrobial therapy fails but clinical signs of infection persist. In this case experience, the authors suggest the use of negative pressure wound therapy (NPWT) for NTM-infected wounds to obtain a faster periprosthetic space closure, shorten healing time, and anticipate breast reimplantation.

Case report: This case report describes the successful application of NPWT to manage wound healing after breast removal in a 60-year-old female who underwent secondary breast augmentation 7 years before. The patient presented with an M. abscessus infection of the left breast after lung segmentectomy that persisted post-implant removal and targeted antibiotic therapy. Based on clinical and laboratory findings, the authors opted for a debridement of the periprosthetic space associated to a radical capsulectomy. Application of NPWT for wound drainage and closure allowed a faster recovery, reduced interval from implant removal to reimplantation, and led to a pleasant cosmetic result.

Conclusion: The use of NPWT for wound management after NTM peri-implant infection may help to encourage faster periprosthetic space drainage and closure, thus expediting the timing of a negative culture and breast reimplantation.