Examining the role of antimicrobial irrigation and capsular contracture a systematic review and meta-analysis

James J. Drinane, Tayseer Chowdhry, Thuy Huong Pham, Edmond F Ritter

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Purpose: The purpose of this study was to conduct a meta-analysis to determine if irrigation of breast implant pockets with antibiotics reduces the rate of capsular contracture (CC). Capsular contracture is the most common complication after primary augmentation mammoplasty, yet its etiology remains cryptogenic. Methods: PubMed was searched for publications from January 1 of 2000 through October of 2015. Studies with the following criteria were included: primary breast augmentation with implants, use of antimicrobial irrigation (AMI), and documentation of CC. The primary outcome studied was incidence of CC. The quality of included studies was assessed independently. Studies were meta-analyzed to obtain a pooled odds ratio (OR) describing the effect of AMI on CC. Results: The meta-analysis included 8 studies and 10,923 patients. A total of 5348 patients received AMI, and 5575 patients did not. Our analysis revealed that the combined AMI, the antibiotic irrigation subgroup, and the iodine subgroup were associated with an increased propensity for CC [OR, 2.60; 95% confidence interval (CI), 2.3-2.94, I2 = 97%, P < 0.00001; OR, 1.42; 95% CI, 1.14-1.78, 2I = 89%, P < 0.00001; OR, 0.54; 95% CI, 0.24-1.22, P = 0.05; 2I = 73], respectively. Conclusions: Antimicrobial irrigation of implant pockets fails to reduce the propensity for CC. The authors recommend that further prospective multicenter trials be conducted to further elucidate the role of antibiotic irrigation in CC.

Original languageEnglish (US)
Pages (from-to)107-114
Number of pages8
JournalAnnals of Plastic Surgery
Volume79
Issue number1
DOIs
StatePublished - 2017

Fingerprint

Contracture
Meta-Analysis
Odds Ratio
Confidence Intervals
Anti-Bacterial Agents
Breast Implants
Mammaplasty
PubMed
Iodine
Documentation
Multicenter Studies
Publications
Breast
Incidence

Keywords

  • Antibiotic irrigation
  • Breast augmentation
  • Capsular contracture
  • Meta-analysis

ASJC Scopus subject areas

  • Surgery

Cite this

Examining the role of antimicrobial irrigation and capsular contracture a systematic review and meta-analysis. / Drinane, James J.; Chowdhry, Tayseer; Pham, Thuy Huong; Ritter, Edmond F.

In: Annals of Plastic Surgery, Vol. 79, No. 1, 2017, p. 107-114.

Research output: Contribution to journalReview article

Drinane, James J. ; Chowdhry, Tayseer ; Pham, Thuy Huong ; Ritter, Edmond F. / Examining the role of antimicrobial irrigation and capsular contracture a systematic review and meta-analysis. In: Annals of Plastic Surgery. 2017 ; Vol. 79, No. 1. pp. 107-114.
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AB - Purpose: The purpose of this study was to conduct a meta-analysis to determine if irrigation of breast implant pockets with antibiotics reduces the rate of capsular contracture (CC). Capsular contracture is the most common complication after primary augmentation mammoplasty, yet its etiology remains cryptogenic. Methods: PubMed was searched for publications from January 1 of 2000 through October of 2015. Studies with the following criteria were included: primary breast augmentation with implants, use of antimicrobial irrigation (AMI), and documentation of CC. The primary outcome studied was incidence of CC. The quality of included studies was assessed independently. Studies were meta-analyzed to obtain a pooled odds ratio (OR) describing the effect of AMI on CC. Results: The meta-analysis included 8 studies and 10,923 patients. A total of 5348 patients received AMI, and 5575 patients did not. Our analysis revealed that the combined AMI, the antibiotic irrigation subgroup, and the iodine subgroup were associated with an increased propensity for CC [OR, 2.60; 95% confidence interval (CI), 2.3-2.94, I2 = 97%, P < 0.00001; OR, 1.42; 95% CI, 1.14-1.78, 2I = 89%, P < 0.00001; OR, 0.54; 95% CI, 0.24-1.22, P = 0.05; 2I = 73], respectively. Conclusions: Antimicrobial irrigation of implant pockets fails to reduce the propensity for CC. The authors recommend that further prospective multicenter trials be conducted to further elucidate the role of antibiotic irrigation in CC.

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