Background: With the rise in the mastectomy rate, the number of patients who choose to undergo postmastectomy reconstruction has been increasing, and implant-based procedures are the most performed methods for postmastectomy breast reconstruction. Among the possible complications, the most feared is the loss of reconstruction. It can be related to several reasons, but one of the most common is infection of the implant, which can lead to prolonged antibiotic treatment, undesired additional surgical procedures, increased incidence of capsular contracture, and unsatisfactory aesthetics results, with a huge psychological impact on patients. Aims: The primary intent of this study is to analyze the status of infection rates at our institution and evaluate the effectiveness of our prevention protocol since its introduction. Secondly, we compared data of the surgical site infections (SSIs) after implant-based breast reconstruction at Trieste Hospital, where the protocol has been employed since 2020, and in another center, where plastic surgeons of our team are involved, with different prevention procedures. Methods and Results: We enrolled 396 female patients, who underwent implant-based breast reconstruction, using definitive mammary implants or breast tissue expanders, with or without ADM (acellular dermal matrix), both for breast cancer and risk-reducing surgery in BRCA1/2 patients. Patients treated at the Hospital of Trieste, with the use of the prevention protocol, were considered the experimental group (group 1), while patients treated in Gorizia by the same breast team with standardized best-practice rules, but without the use of the prevention protocol, were considered the control group (group 2). Infected patients were 5 in the first group (1.7%) and 8 in the second one (7.9%), with a global infection rate of 3.2%. Conclusion: After the introduction of our prevention protocol, we faced a lower incidence of infection after breast surgery with implants or tissue expanders.
背景：随着乳房切除术率的上升，选择接受乳房切除术后重建的患者数量不断增加，其中基于植入物的重建手术是最常用的方法。在可能出现的并发症中，最令人担忧的是重建失败。这可能与多种原因相关，但最常见的原因之一是植入物感染，这可能导致长期抗生素治疗、不必要的额外手术、包膜挛缩发生率增加以及美学效果不佳，对患者心理造成巨大影响。 目的：本研究的主要目的是分析我院植入物感染率的现状，并评估自预防方案实施以来的有效性。其次，我们比较了的里雅斯特医院（自2020年起采用该预防方案）与另一中心（由我院整形外科团队参与但采用不同预防措施）在基于植入物的乳房重建术后手术部位感染（SSI）的数据。 方法与结果：我们纳入了396例接受基于植入物乳房重建的女性患者，这些患者使用永久性乳房植入物或组织扩张器，部分联合使用脱细胞真皮基质（ADM），手术适应症包括乳腺癌治疗及BRCA1/2患者的风险降低手术。在的里雅斯特医院接受治疗并采用预防方案的患者被列为实验组（第1组），而在戈里齐亚由同一乳腺团队采用标准化最佳实践规则但未使用预防方案治疗的患者被列为对照组（第2组）。感染患者在第1组有5例（1.7%），第2组有8例（7.9%），总体感染率为3.2%。 结论：在实施我们的预防方案后，采用植入物或组织扩张器的乳房手术后感染发生率显著降低。
肿瘤(癌症)患者之家