ArticleThe breast journal2026
An Algorithm for Salvage of Implant-Threatening Complications in Breast Reconstruction.
Article in The breast journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- An Algorithm for Salvage of Implant-Threatening Complications in Breast Reconstruction.The breast journal · 2026Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImplant-based breast reconstruction is associated with postoperative infectious and wound-related complications that may compromise reconstructive outcomes, particularly in cohorts predominantly undergoing immediate reconstruction. Optimal management remains controversial, with no universally accepted salvage algorithm.
methodsWe conducted a retrospective cohort study of 198 patients (285 breasts) who underwent implant-based reconstruction between 2013 and 2023, the majority of whom underwent immediate reconstruction. Implant-threatening complications were defined as surgical site infection according to Centers for Disease Control and Prevention (CDC) criteria, full-thickness skin necrosis, or deep wound dehiscence. A standardized institutional salvage protocol incorporating antibiotic therapy with or without surgical intervention was applied. Outcomes included implant salvage and final reconstruction status at the end of follow-up, and logistic regression was used to identify predictors of salvage failure.
resultsImplant-threatening complications occurred in 28.3% of patients, with salvage achieved in 51.8% of cases. All patients in the salvage group achieved final reconstruction, compared to 44.4% in the nonsalvage group (p < 0.01). The most common complications were skin necrosis and wound dehiscence, followed by infection, and Gram-negative organisms predominated among culture-positive cases. Resistant organisms (p = 0.04), implant extrusion (p = 0.008), and prior radiation therapy (p = 0.019) were independent predictors of salvage failure.
conclusionA protocol-based salvage approach may facilitate implant preservation and improve final reconstruction rates. Early, case-specific conservative management, tailored to local microbiologic patterns, may optimize outcomes.
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