338 Management of Periprosthetic Breast Infection: A Systematic Review and Meta-Analysis

Abstract

Aim: This systematic review and meta-analysis aims to synthesize the current evidence and establish the efficacy of the various managements of infected breast implants. Method: A comprehensive search in the MEDLINE, EMBASE and CENTRAL databases was conducted for primary clinical studies reporting on the management of infected breast implants from 1946 to September 2019. The primary outcome measure was the proportion of patients with successful treatment. Results: Nineteen articles involving 1044 patients were included. Mild infections seen in 29.00%(95%CI=11.51% to 50.58%) of the patients were treated exclusively with antibiotics, of which, 81.41%(95%CI=57.82% to 96.63%) were successfully treated without the need for surgical intervention. Overall, 39.01%(95%CI=21.41% to 58.23%) of the patients underwent surgical salvage of the infected breast implants, of which 84.56% (95%CI= 74.92% to 92.20%) successfully retained the salvaged implants without infection recurrence. Meanwhile, 35.01%(95%CI= 27.01% to 43.57%) of the patients underwent explantation of the infected breast implant, of which, only 39.02%(95%CI=23.93% to 55.28%) had re-insertion of a new implant on a later date, and 4.99% (95%CI=1.66% to 9.99%) of these patients had recurrence of infection requiring removal of the infected implant. The commonest complication was capsular contracture, which was reported in 10.78%(95%CI=4.41% to 19.49%) of the patients. Changes in the quality of life and cost implications were not reported. Conclusions: This study consolidates current available evidence on the management of infected breast implants, which could assist decision making and improve patient education, however current data is limited by the lack of level-1 evidence.