Staph A Infection 6-weeks Post-op Double Mastectomy with Reconstruction, How will this Effect Healing?

Question

Can you please tell me more about the success rate of healing cellulitis in a reconstructed breast using IV antibiotics (Penicillin G) vs. surgical route? Can cellulitis reoccur? I'm 39 and BRCA1+. I had a bilateral double mastectomy w/reconstruction 7-weeks ago. 1 breast received cohesive gel implant (cellultis side), the other breast has tissue exp. (as skin wouldnt adequately stretch over implant). Also had 3 nodes removed. Pathology was clear of cancer. Any advice/info most appreciated!

Peter A. Aldea, MD · Answer

Your question would best be answered by your surgeon. In general, it is rare for a surgical infection to come on 6 weeks after surgery unless the tissue has been radiated, has a poor blood supply and there was spread from somewhere else in the body. Aggressive intravenous antibiotic therapy is the only answer and if it is not successful in clearing the infection the underlying implant or tissue expander may have to be removed IF it has been colonized by the bacteria.

	You need to be seen frequently by the surgeon who can best monitor your progress and advise you which would be your best option.

Robert Whitfield, MD · Answer

These are difficult cases once there has been cellulitis.  This is even more true if it happens early after surgery.  Following up with your surgeon is important.  You also may have to consider more survey with another technique like the DIPE flap.Three
basic forms of breast reconstruction exist. You can use your own tissue,
implants or a combination of the previous two techniques. Your own tissue can
be used in the form of the DIEP flap, PAP flap, SGAP flap or fat grafting.
Implants can be done in one stage or two stage. Two stage reconstructions are
started by placing expanders at the time of mastectomy. Once they expanders are
placed they are able to be inflated as determined by wound healing. The final
time consists of combining any of the above techniques.

If
you are interested in being seen in Austin please give us a call.  I know
this is a difficult time for you.  The majority of my practice is devoted
to reconstruction for women with breast cancer or who are BRCA+

Samir Shureih, MD · Answer

You can treat cellulitis, , if it is limited can be treated well but the treatment has to be aggressive because you have an implant and a tissue expander, to be able to salvage the implant and tissue expander.

	If the infection is around the implant or the tissue expander, then th eimplAnt has to be removed to be able to treat the infection appropriately. Then you have to wait  at least 6 months before you can have the implant or tissue expander inserted back again.

Staph A Infection 6-weeks Post-op Double Mastectomy with Reconstruction, How will this Effect Healing?

Answers (3)

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