Rinse But Don’t Repeat: Single Application V.A.C. VERAFLO Salvages Infected Breast Prostheses

Introduction:. Existing salvage protocols for infected breast prostheses using negative pressure wound therapy with instillation and dwell (NPWTi-d) require multiple returns to the operating room and prolonged length of stay. We present our expedited salvage protocol and discuss outcomes and associa...

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Autores principales:	Lauren E. Antognoli, MD, Devinder P. Singh, MD, Salman Choudhry, MD, Justin Turcotte, PhD, MBA, Luther H. Holton, III, MD
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer 2021
Materias:	Surgery RD1-811
Acceso en línea:	https://doaj.org/article/d8e352234b41413b9c392444795a7f48
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spelling	oai:doaj.org-article:d8e352234b41413b9c392444795a7f482021-11-25T07:57:35ZRinse But Don’t Repeat: Single Application V.A.C. VERAFLO Salvages Infected Breast Prostheses2169-757410.1097/GOX.0000000000003896https://doaj.org/article/d8e352234b41413b9c392444795a7f482021-10-01T00:00:00Zhttp://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003896https://doaj.org/toc/2169-7574Introduction:. Existing salvage protocols for infected breast prostheses using negative pressure wound therapy with instillation and dwell (NPWTi-d) require multiple returns to the operating room and prolonged length of stay. We present our expedited salvage protocol and discuss outcomes and associated costs savings. Methods:. Using a retrospective review, we identified 25 consecutive patients (27 breasts) with peri-prosthetic breast infection. Nine patients (10 breasts) underwent removal of infected breast prostheses followed by autologous or staged implant-based reconstruction. Sixteen patients (17 breasts) underwent our single application salvage protocol. A cost analysis was performed comparing the two groups, and an economic model was used to project the cost savings associated with using single application NPWTi-d protocol. Results:. Fifteen of the 16 patients (94%) who underwent single application NPWTi-d had successful implant salvage. Average duration of NPWTi-d was 2 days, 7 hours, and average length of stay was 4.43 days. Compared to control, patients who received the single application protocol required significantly fewer hospitalizations and office visits. A total savings of $58,275 could have been achieved by using the single application NPWTi-d protocol in the patients who did not undergo NPWTi-d. Conclusions:. Single application of NPWTi-d is a simple, safe, and cost-effective technique for salvage of breast prostheses, with 94% success rate, even in immunocompromised patients and severe infection. Compared to previous protocols, ours requires fewer trips to the operating room, shorter length of stay, and more permanent implants placed during salvage. Our protocol is also associated with fewer office visits and fewer returns to the operating room.Lauren E. Antognoli, MDDevinder P. Singh, MDSalman Choudhry, MDJustin Turcotte, PhD, MBALuther H. Holton, III, MDWolters KluwerarticleSurgeryRD1-811ENPlastic and Reconstructive Surgery, Global Open, Vol 9, Iss 10, p e3896 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Surgery RD1-811
spellingShingle	Surgery RD1-811 Lauren E. Antognoli, MD Devinder P. Singh, MD Salman Choudhry, MD Justin Turcotte, PhD, MBA Luther H. Holton, III, MD Rinse But Don’t Repeat: Single Application V.A.C. VERAFLO Salvages Infected Breast Prostheses
description	Introduction:. Existing salvage protocols for infected breast prostheses using negative pressure wound therapy with instillation and dwell (NPWTi-d) require multiple returns to the operating room and prolonged length of stay. We present our expedited salvage protocol and discuss outcomes and associated costs savings. Methods:. Using a retrospective review, we identified 25 consecutive patients (27 breasts) with peri-prosthetic breast infection. Nine patients (10 breasts) underwent removal of infected breast prostheses followed by autologous or staged implant-based reconstruction. Sixteen patients (17 breasts) underwent our single application salvage protocol. A cost analysis was performed comparing the two groups, and an economic model was used to project the cost savings associated with using single application NPWTi-d protocol. Results:. Fifteen of the 16 patients (94%) who underwent single application NPWTi-d had successful implant salvage. Average duration of NPWTi-d was 2 days, 7 hours, and average length of stay was 4.43 days. Compared to control, patients who received the single application protocol required significantly fewer hospitalizations and office visits. A total savings of $58,275 could have been achieved by using the single application NPWTi-d protocol in the patients who did not undergo NPWTi-d. Conclusions:. Single application of NPWTi-d is a simple, safe, and cost-effective technique for salvage of breast prostheses, with 94% success rate, even in immunocompromised patients and severe infection. Compared to previous protocols, ours requires fewer trips to the operating room, shorter length of stay, and more permanent implants placed during salvage. Our protocol is also associated with fewer office visits and fewer returns to the operating room.
format	article
author	Lauren E. Antognoli, MD Devinder P. Singh, MD Salman Choudhry, MD Justin Turcotte, PhD, MBA Luther H. Holton, III, MD
author_facet	Lauren E. Antognoli, MD Devinder P. Singh, MD Salman Choudhry, MD Justin Turcotte, PhD, MBA Luther H. Holton, III, MD
author_sort	Lauren E. Antognoli, MD
title	Rinse But Don’t Repeat: Single Application V.A.C. VERAFLO Salvages Infected Breast Prostheses
title_short	Rinse But Don’t Repeat: Single Application V.A.C. VERAFLO Salvages Infected Breast Prostheses
title_full	Rinse But Don’t Repeat: Single Application V.A.C. VERAFLO Salvages Infected Breast Prostheses
title_fullStr	Rinse But Don’t Repeat: Single Application V.A.C. VERAFLO Salvages Infected Breast Prostheses
title_full_unstemmed	Rinse But Don’t Repeat: Single Application V.A.C. VERAFLO Salvages Infected Breast Prostheses
title_sort	rinse but don’t repeat: single application v.a.c. veraflo salvages infected breast prostheses
publisher	Wolters Kluwer
publishDate	2021
url	https://doaj.org/article/d8e352234b41413b9c392444795a7f48
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Rinse But Don’t Repeat: Single Application V.A.C. VERAFLO Salvages Infected Breast Prostheses

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