Wound Complications After Breast Reconstruction Procedures
To reduce the risk of wound complications, certain high-risk patients may benefit from delayed rather than immediate implant reconstruction after mastectomy, according to research published by Margaret A. Olsen, PhD, MPH, of Washington University, St. Louis, and colleagues, in JAMA.
The researchers sought to compare the incidence of surgical-site infection and noninfectious wound complications associated with implant and autologous immediate, delayed, and secondary breast reconstruction after mastectomy. This retrospective cohort study included 17,293 women who underwent mastectomy from January 1, 2004, through December 31, 2011.
The incidence of surgical-site infection was significantly higher after immediate implant reconstruction, compared with delayed and secondary implant reconstructions. (8.9%, 6.0%, and 3.3%, respectively). Similar results were found for noninfectious wound complications. However, the incidence of surgical-site infection was similar after immediate, delayed, and secondary autologous reconstructions (9.8%, 13.9%, and 11.6%, respectively).
Not only were surgical-site infections and noninfectious wound complications more prevalent in women who underwent immediate implant reconstruction, women who had these complications after their procedure had a higher risk for subsequent complications after secondary reconstruction. “The risk for complications should be carefully balanced with the psychosocial and technical benefits of immediate reconstruction,” the investigators reported.