Use of gentamicin collagen sponges for the treatment of periprosthetic breast implant infection.

Abstract

The infection of a breast implant or tissue expander is a major complication with significant psychological and medical ramifications. The incidence has been reported to range from 1.1% in cosmetic augmentations to as high to 24% in a series of reconstructive cases. Gentamicin Surgical Implant is a surgical implant comprised of a lyophilised collagen matrix impregnated with a broad-spectrum antibiotic. When placed in the operative field, it achieves very high local concentrations of drug several fold above the minimal inhibitory concentrations; and the collagen carrier is absorbed. Its beneficial use has been reported in other fields of surgery. Gentamicin sponges were used in four cases of periprosthetic infections. The implants were removed, the pockets cleaned with pulse lavage and the implants were replaced, together with a gentamicin collagen implant. This was followed by a 6-week systemic antibiotic regimen. The patients had uneventful recovery and have not developed capsular contracture. Gentamicin collagen sponges may be used as an adjunct in the salvage of infected breast implants. Periprosthetic infections, as well as the use of gentamicin, are reviewed.