Arch Plast Surg.  2018 Nov;45(6):542-549. 10.5999/aps.2018.00437.

Bacterial profile of suction drains and the relationship thereof to surgical-site infections in prosthetic breast reconstruction

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea. yesanam2@korea.ac.kr

Abstract

BACKGROUND
Despite the increasing popularity of prosthetic breast reconstruction, scant data exist on the microbiological profile of drainage fluid from closed-suction drains and the relationship thereof to surgical-site infections (SSIs) in breast reconstruction surgery. This study aimed to determine whether bacteria isolated from drainage fluid were associated with the development of SSIs, and whether the bacterial profile of drainage fluid could be a clinically useful predictor of SSIs.
METHODS
We performed a retrospective chart review of 61 women who underwent tissue expander/implant or direct-to-implant reconstructions. Patient demographics and culture studies of drainage fluid from suction drains collected on postoperative day 7 were evaluated.
RESULTS
Sixteen patients (26.23%) were culture-positive, and 45 patients (73.77%) were culture-negative. The most frequently isolated bacteria were coagulase-negative staphylococci, followed by Staphylococcus aureus. SSIs were diagnosed in seven patients and were mostly resolved by systemic antibiotics; however, the tissue expander or implant was explanted in two patients. Positive culture of drainage fluid from closed-suction drains was significantly associated with the development of SSIs (P < 0.05). The positive predictive value was 37.50%,and the negative predictive value was 97.78%.
CONCLUSIONS
To our knowledge, this study is the first to demonstrate a significant association between the microbiological profile of drainage fluid from closed-suction drains and the development of SSIs in patients with prosthetic breast reconstructions. The high negative predictive value suggests that microbial testing of drainage fluid from closed-suction drains may have clinical utility. Further prospective studies with larger sample sizes are required to confirm our findings.

Keyword

Mammoplasty; Breast implants; Suction; Infection; Bacteria

MeSH Terms

Anti-Bacterial Agents
Bacteria
Breast Implants
Breast*
Demography
Drainage
Female
Humans
Mammaplasty*
Prospective Studies
Retrospective Studies
Sample Size
Staphylococcus aureus
Suction*
Tissue Expansion Devices
Anti-Bacterial Agents
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