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Irrigating Breast Implant Pockets with a Triple Antibiotic Solution Fails to Reduce Capsular Contracture Incidence and Severity
James J. Drinane, B.Sci., Medical Student¹;
Ronald S. Bergman, D.O., Adjunct Clinical Professor^1, Attending Physician²;
Bryan L. Folkers, D.O., Clinical Professor¹, Attending Physician^,2;
Matthew J. Kortes, M.D., Research Assistant²
1. Des Moines University College of Osteopathic Medicine and Surgery, 3200 Grand Ave, Des Moines, IA 50312
2. Bergman/Folkers Plastic Surgery, 2000 Grand Ave, Des Moines, IA 50312
Abstract:
Background: Capsular Contracture is the most common complication following primary augmentation mammoplasty. It remains poorly understood. Its etiology 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.
Objective: The purpose of this study was to determine if antibiotic irrigation was more effective that saline irrigation alone.
Methods: A retrospective chart review was undertaken for 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. The only difference in surgical technique was the use of antibiotic irrigation by Surgeon B. A Chi Squared test and ANOVA with predetermined 95% confidence intervals were performed.
Results: 25 patient records were analyzed. 14 of Surgeon A’s patients were included, ranging in age from 19 to 50 with a mean follow-up time of 1.6 years. 11 of Surgeon B’s patients were included ranging in age from 22 to 48 with a mean follow-up time of 1.1 years. Rate of capsular contracture was 7.1% (Surgeon A) and 10% (Surgeon B). Chi Squared statistic was found to be 0.1247 (P=0.72) and ANOVA 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 to sterile saline. The authors recommend the practice of irrigating implant pockets with antibiotics be discontinued.