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Antimicrobial Irrigation Difference in Implant-Based Reconstruction: A Cohort Study of Triple-Antibiotic Solution versus Chlorhexidine-Gluconate Based Solution
Hannah Soltani
2, Ryan Lin
2, Alexandra Junn
2, Isabel Snee*
1, Rachel N. Rohrich
2, Sami Ferdousian
2, Danny S. Chamaa
1, Lucy De La Cruz
3, Samer Jabbour
2, Kenneth Fan
2
1Georgetown University School of Medicine, Washington, DC, United States. 2Plastic & Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC, United States. 3Breast Surgery, MedStar Georgetown University Hospital, Washington, DC, United States.
Background: Antimicrobial irrigation solutions are a widely practiced method to reduce infection and capsular contracture following mastectomy in implant-based breast reconstruction. This study compares the postoperative outcomes between a Triple Antibiotic Solution (TAS) and a 0.05% Chlorhexidine gluconate solution (CHG).
Methods: A multi-institutional retrospective cohort study was conducted, reviewing 297 breast reconstructions in 171 patients between April 2020 and July 2024. Patients were divided into two groups based on the use of TAS or CHG for implant irrigation. Postoperative complications, including hematoma, capsular contracture, infection, and the need for secondary procedures, were assessed at ≤30 and ≥60 days. Comparative statistical analysis was performed using t-tests, Wilcoxon rank-sum tests, Chi-squared tests, and multivariate regression.
Results: Of the 297 breast reconstructions, TAS was used in 226 breasts and CHG in 71 breasts. There were no statistically significant differences between the TAS and CHG groups in <30-day complications such as hematoma [7 (2.4%) vs. 0 (0%), p=0.14], surgical site infection [2 (0.9%) vs. 0 (0%), p=0.58], or unplanned return to the operating room [6 (2.7%) vs. 0 (0%), p=0.56. Similarly, no significant differences were observed between TAS and CHG groups in ≥60-day outcomes, including capsular contracture [5 (2.2%) vs. 2 (2.4%), p=0.53].
Conclusion: TAS and CHG had no significant differences in rates of post-operative complications in IBR. Further prospective studies are warranted to establish optimal irrigation protocols in reconstructive breast surgery.
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