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Erschienen in: Aesthetic Plastic Surgery 1/2017

28.12.2016 | Case Report

Innovative Management of Implant Exposure in ADM/Implant-Based Breast Reconstruction with Negative Pressure Wound Therapy

verfasst von: Antonello Accurso, Nicola Rocco, Giuseppe Accardo, Paola Reale, Carmela Salerno, Edi Mattera, Francesco D’Andrea

Erschienen in: Aesthetic Plastic Surgery | Ausgabe 1/2017

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Abstract

Introduction

One-stage implant-based breast reconstruction has been recently improved by the introduction of biological [acellular dermal matrix (ADM)] and synthetic meshes. Advantages of ADMs in implant-based breast reconstruction derive from the expansion of the space available for the direct positioning of an implant, but their use could be associated with several complications. Although the majority of complications can be easily managed, mistakes in dealing with the first clinical signs of a potential adverse event can lead to implant loss.

Case Presentation

We report a case of ADM/implant exposure following NAC-sparing mastectomy and immediate implant-based reconstruction, successfully managed with an innovative staged treatment using negative pressure wound therapy, which allowed a rapid re-positioning of the prosthesis after complete clearance of bacteria from the implant pocket.

Discussion

The safest strategy to manage implant exposure and concomitant bacterial growth is reported to be implant removal and delayed re-positioning after several months, following prolonged targeted antibiotic therapy. Our case shows how a short-time implant re-positioning following implant removal for implant exposure could be successfully pursued thanks to the shrewd use of negative pressure wound therapy with great advantages in terms of patient satisfaction and post-operative quality of life, offering women experiencing this complication the option of not delaying reconstruction for months after resolution of the complication, potentially avoiding major surgical procedures such as autologous tissue reconstructions.

Level of Evidence V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
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Metadaten
Titel
Innovative Management of Implant Exposure in ADM/Implant-Based Breast Reconstruction with Negative Pressure Wound Therapy
verfasst von
Antonello Accurso
Nicola Rocco
Giuseppe Accardo
Paola Reale
Carmela Salerno
Edi Mattera
Francesco D’Andrea
Publikationsdatum
28.12.2016
Verlag
Springer US
Erschienen in
Aesthetic Plastic Surgery / Ausgabe 1/2017
Print ISSN: 0364-216X
Elektronische ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-016-0739-1

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