Implant Based Reconstruction: An Audit of Practice in a Semi-Rural District General Hospital
Association of Breast Surgery ePoster Library. Gomez K. 05/13/19; 257110; P066
Kelvin Gomez
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P066
Topic: Breast surgery
Introduction: Implant-based procedures are the most commonly performed method for post-mastectomy breast reconstruction. Infection is the most significant complication as they are almost always associated with implant loss. Reported infection rates range from 1-35%. Our audit aimed to record our infection rates and to see if evolution of our protocols have made a difference. Methods A retrospective casenote review was undertaken on all patients who underwent implant based breast reconstructions at Nevill Hall Hospital (NHH) between January 2014 and July 2018. Datasets produced include type of surgery to breast and axilla, type of neoadjuvant or adjuvant treatment and complication rates. Statistical analysis was performed using SPSS version 21.0 and a p value of <0.05 was deemed significant. Results: 63 patients underwent implant based procedures during this time-period. 3 patients had revision surgery performed at NHH after having their initial surgery elsewhere and were excluded from statistical analysis. All implants were inserted in the sub-pectoral plane. The overall implant loss rate is 6.7% (4 patients); one patient per year from 2014-2017. Staphylococcusspecieswere isolated in 50% of infected implants. 75% of infected implants had a titanium mesh cover.Adjuvant radiotherapy or chemotherapy on their own did not produce a significant difference in implant infection rates. When used in combination however, the infection rate rose to 14.2%. Conclusions: trict adherence to infection reducing protocols have maintained our infection rates at lower than the national average; however, there is still room for improvement as our practice continues to evolve.
Topic: Breast surgery
Introduction: Implant-based procedures are the most commonly performed method for post-mastectomy breast reconstruction. Infection is the most significant complication as they are almost always associated with implant loss. Reported infection rates range from 1-35%. Our audit aimed to record our infection rates and to see if evolution of our protocols have made a difference. Methods A retrospective casenote review was undertaken on all patients who underwent implant based breast reconstructions at Nevill Hall Hospital (NHH) between January 2014 and July 2018. Datasets produced include type of surgery to breast and axilla, type of neoadjuvant or adjuvant treatment and complication rates. Statistical analysis was performed using SPSS version 21.0 and a p value of <0.05 was deemed significant. Results: 63 patients underwent implant based procedures during this time-period. 3 patients had revision surgery performed at NHH after having their initial surgery elsewhere and were excluded from statistical analysis. All implants were inserted in the sub-pectoral plane. The overall implant loss rate is 6.7% (4 patients); one patient per year from 2014-2017. Staphylococcusspecieswere isolated in 50% of infected implants. 75% of infected implants had a titanium mesh cover.Adjuvant radiotherapy or chemotherapy on their own did not produce a significant difference in implant infection rates. When used in combination however, the infection rate rose to 14.2%. Conclusions: trict adherence to infection reducing protocols have maintained our infection rates at lower than the national average; however, there is still room for improvement as our practice continues to evolve.
P066
Topic: Breast surgery
Introduction: Implant-based procedures are the most commonly performed method for post-mastectomy breast reconstruction. Infection is the most significant complication as they are almost always associated with implant loss. Reported infection rates range from 1-35%. Our audit aimed to record our infection rates and to see if evolution of our protocols have made a difference. Methods A retrospective casenote review was undertaken on all patients who underwent implant based breast reconstructions at Nevill Hall Hospital (NHH) between January 2014 and July 2018. Datasets produced include type of surgery to breast and axilla, type of neoadjuvant or adjuvant treatment and complication rates. Statistical analysis was performed using SPSS version 21.0 and a p value of <0.05 was deemed significant. Results: 63 patients underwent implant based procedures during this time-period. 3 patients had revision surgery performed at NHH after having their initial surgery elsewhere and were excluded from statistical analysis. All implants were inserted in the sub-pectoral plane. The overall implant loss rate is 6.7% (4 patients); one patient per year from 2014-2017. Staphylococcusspecieswere isolated in 50% of infected implants. 75% of infected implants had a titanium mesh cover.Adjuvant radiotherapy or chemotherapy on their own did not produce a significant difference in implant infection rates. When used in combination however, the infection rate rose to 14.2%. Conclusions: trict adherence to infection reducing protocols have maintained our infection rates at lower than the national average; however, there is still room for improvement as our practice continues to evolve.
Topic: Breast surgery
Introduction: Implant-based procedures are the most commonly performed method for post-mastectomy breast reconstruction. Infection is the most significant complication as they are almost always associated with implant loss. Reported infection rates range from 1-35%. Our audit aimed to record our infection rates and to see if evolution of our protocols have made a difference. Methods A retrospective casenote review was undertaken on all patients who underwent implant based breast reconstructions at Nevill Hall Hospital (NHH) between January 2014 and July 2018. Datasets produced include type of surgery to breast and axilla, type of neoadjuvant or adjuvant treatment and complication rates. Statistical analysis was performed using SPSS version 21.0 and a p value of <0.05 was deemed significant. Results: 63 patients underwent implant based procedures during this time-period. 3 patients had revision surgery performed at NHH after having their initial surgery elsewhere and were excluded from statistical analysis. All implants were inserted in the sub-pectoral plane. The overall implant loss rate is 6.7% (4 patients); one patient per year from 2014-2017. Staphylococcusspecieswere isolated in 50% of infected implants. 75% of infected implants had a titanium mesh cover.Adjuvant radiotherapy or chemotherapy on their own did not produce a significant difference in implant infection rates. When used in combination however, the infection rate rose to 14.2%. Conclusions: trict adherence to infection reducing protocols have maintained our infection rates at lower than the national average; however, there is still room for improvement as our practice continues to evolve.
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