In Aug. 2011 I Had a Nipple & Skin Sparing Bilateral Mastectomy. I'm Very Fortunate to Have Been a Good Candidate for This, but I keep having a recurring infection(red, draining & PS used term skin thinning but no fever)in rt breast after 2 tries w/bactrim PS arrated area & replaced skin expander so I could start chemo & it did well. I just finished my 3rd chemo treatment(I'm half way through but still have a yr of Herceptin)the infection has returned & looks worse. PS put me on clindamysin hcl & doesnt seem to be helping so far (3rd day) & I'm afraid the infection will spread to other areas. Should I be concerned?
An Infection Keeps Reoccurring Following Surgery, Should I Worry?
Doctor Answers 3
Recurrent implant infections
Treating a potentially infected implant/tissue expander with antibiotics demands close observation, which I am sure your surgeon is doing. Are you aware if you also had an allograft placed during your reconstruction? Another possibility is a condition called "red breast syndrome" which is still a poorly understood reaction that occurs with allograft. In any case, these signs and symptoms are still assumed to be infection until proven otherwise. A relatively new condition that is a frequent cause of implant infections is called a "biofilm," which occurs in either cosmetic or reconstructive breast surgery. A common source of biofilm infections is bacterial contamination from the nipple ducts. Biofilms are very difficult to treat due to the inherent properties of the bacteria as well as the presence of multiple organisms. Unfortunately you may not be a candidate for further implant reconstructions. Are you a candidate for an autologous reconstruction (i.e. your own tissue)? If so, this may be an alternative solution to reconstruct your breasts.
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First you are on chemotherapy and that makes you more prone to infection. The fact that you keep having recurrent infections with a tissue expandeder inlace, makes me think of infection involving the expandeder If that is the case then the expanded needs to come out and the pocket derided and cultures for every thing is taken Intravenous antibiotics then antibiotics by mouth. A second opinion may be in order.
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I am not sure if the infection involves the expander or the skin only. If the infection has been limited to the skin,antibiotics and local wound care will be enough. The recurrence and resistance to the antibiotics makes me to be concerned about the implant infection.