Evidence map›Paper›PMID 38678812›Full record

ArticleJournal of plastic, reconstructive & aesthetic surgery : JPRAS2024

Impact of post-operative infection on revision procedures in breast reconstruction: A marketscan database analysis.

Shannon D Francis, Augustine W Kang, Bhagvat J Maheta, Brian R Sangalang, Sophia Salingaros, Robin T Wu, Rahim S Nazerali

Abstract read
In one paragraph

Article in Journal of plastic, reconstructive & aesthetic surgery : JPRAS, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Shannon D FrancisStanford University School of Medicine, Stanford, CA, USA.
Augustine W KangStanford University School of Medicine, Stanford, CA, USA.
Bhagvat J MahetaCalifornia Northstate University College of Medicine, Elk Grove, CA, USA.
Brian R SangalangUniversity of California Riverside School of Medicine, Riverside, CA, USA.
Sophia SalingarosWeill Cornell Medical College, New York City, NY, USA.
Robin T WuDivision of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
Rahim S NazeraliDivision of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: rahimn@stanford.edu.

Funding

Stanford Center for Clinical & Translational Education and Research (Spectrum)UL1TR003142 · NCATS · STANFORD UNIVERSITY · PI O'HARA, RUTH M · 2019 to 2023
$45.0M
NCATS NIH HHS UL1 TR003142
6 · The paper itself

Abstract

backgroundEsthetic complications, such as capsular contracture and soft-tissue contour defects, hinder the desired outcomes of breast reconstruction. As subclinical infection is a prevailing theory behind capsular contracture, we investigated the effects of post-operative infections on these issues and revision procedures.

methodsWe conducted a retrospective database study (2007-2021) on breast reconstruction patients from the MarketScan® Databases. Esthetic complications were defined by their associated revision procedures and queried via CPT codes. Severe capsular contracture (Grade 3-4) was defined as requiring capsulotomy or capsulectomy with implant removal or replacement. Moderate and severe soft-tissue defects were determined by the need for fat grafting or breast revision, respectively. Generalized linear models were used, adjusting for comorbidities and surgical factors (p < 0.05).

resultsWe analyzed the data on 62,510 eligible patients. Post-operative infections increased the odds of capsulotomy (OR 1.59, p < 0.001) and capsulectomy (OR 2.30, p < 0.001). They also raised the odds of breast revision for severe soft-tissue defects (OR 1.21, p < 0.001). There was no significant association between infections and fat grafting for moderate defects. Patients who had post-operative infections were also more likely to experience another infection after fat grafting (OR 3.39, p = 0.0018). In two-stage reconstruction, infection after tissue expander placement was associated with greater odds of infection after implant placement.

conclusionPost-operative infections increase the likelihood of developing severe soft-tissue defects and capsular contracture requiring surgical revision. Our data reinforce the role of infections in the pathophysiology of capsular contracture. Additionally, infections elevate the risk of subsequent infections after fat grafting for moderate defects, further increasing patient morbidity.

Indexed as

MammaplastyReoperationSurgical Wound InfectionAdultBreast ImplantationBreast ImplantsDatabases, FactualFemaleHumansImplant Capsular ContractureMiddle AgedRetrospective StudiesBreast reconstructionCapsular contractureMarketScan® DatabasesPost-operative infectionsRevision proceduresSoft-tissue defects

Identifiers

PMID38678812
PMCPMC11616014

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.