Tissue expander and implant based breast reconstruction after mastectomy is becoming a popular operation. Increased patient awareness regarding reconstructive options has led to a steady increase in breast reconstruction over the last decade. Most recently, the widespread use of acellular dermal matrix has put tissue expander and direct-to-implant breast reconstruction at the forefront of our plastic surgery literature. One common topic of discussion that permeates the Journal is how to treat and manage tissue expander and implant infections after reconstruction. In their article, “Salvaging the Infected Breast Tissue Expander: A Standardized Multidisciplinary Approach” in Plastic and Reconstructive Surgery: Global Open, Dr. Viola et al elaborates on one institutions same-day, multidisciplinary approach to TE treatment and salvage in order to reduce the rate of TE removal, hospitalization, and costs.
The authors site an approximate 12% rate of infection after TE reconstruction at their institution, and estimate 50% of those patients proceed to explantation. Subsequent ramifications do not only adversely effect patient morale, but also have a significant impact on overall medical and surgical costs and further delay of radiation and chemotherapy. It is for this compilation of reasons that they sought to introduce a standardized protocol for rapid and reliable management of infected breast tissue expanders, with the ultimate goal of tissue expander salvage.