Surgical site infection after breast reconstruction with silicone implant - a retrospective analysis of risk factors.

Abstract

Introduction: Breast reconstruction using a silicone implant after mastectomy is a common part of the comprehensive treatment of breast cancer patients. One of the most serious complications is implant infection, which can significantly affect the surgical outcome as well as the patient's quality of life. The aim of this study was to analyse the incidence of infectious complications following breast reconstruction with a silicone implant. The study also sought to identify major risk factors, assess possible preventive measures, and compare the findings with data available in the scientific literature. Special attention was paid to immediate versus delayed reconstruction following mastectomy.

Methods: A retrospective analysis was conducted on data from 17 patients who had surgery at Na Františku Hospital in Prague in 2024. Both clinical and surgical variables were evaluated, including the timing of reconstruction (immediate or delayed), incidence of infection, and microbiological findings in relation to the presence of risk factors (smoking, diabetes mellitus, radiotherapy, coagulopathy), reoperation, fat transfer prior to surgery, and length of hospitalization. The distal end of the Redon drain was sent for microbiological examination.

Results: Infection occurred in 7 out of 17 patients, with a higher incidence observed in cases of immediate reconstruction. The most common pathogens identified were Staphylococcus epidermidis and Staphylococcus capitis. The average length of hospitalization was 9.8 days (a median of 8 days). The most frequent complicating factors were immediate reconstruction, smoking (including IQOS), radiotherapy, and diabetes mellitus. A positive impact on reconstruction outcomes was observed in patients who had fat transfer prior to implant placement, which appeared to have a protective effect. Reoperation was required in 5 patients, and in 3 of these cases, implant removal was ultimately necessary.

Conclusion: The importance of identifying risk factors for planning reconstruction and preventing complications was confirmed. Smoking, diabetes mellitus, and radiotherapy are significant risk factors for implant-related infections. Fat transfer prior to implant-based reconstruction may serve as a protective factor.