Alpha Defensin-1 Level Correlates with Periprosthetic Infection Severity following Implant-based Breast Reconstruction.

Sobti, Nikhil; Vishwanath, Neel; Stead, Thor; Rao, Vinay; Soliman, Luke; Breuing, Karl; Kwan, Daniel; Liu, Paul; Schmidt, Scott

Sobti, Nikhil; Vishwanath, Neel; Stead, Thor; Rao, Vinay; Soliman, Luke; Breuing, Karl; Kwan, Daniel; Liu, Paul; Schmidt, Scott.

Afiliación

Sobti N; From the Department of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, R.I.
Vishwanath N; From the Department of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, R.I.
Stead T; From the Department of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, R.I.
Rao V; From the Department of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, R.I.
Soliman L; From the Department of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, R.I.
Breuing K; From the Department of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, R.I.
Kwan D; From the Department of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, R.I.
Liu P; From the Department of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, R.I.
Schmidt S; From the Department of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, R.I.

Plast Reconstr Surg Glob Open ; 12(1): e5543, 2024 Jan.

Article en En | MEDLINE | ID: mdl-38264447

ABSTRACT

ABSTRACT

Background:

Accurate diagnosis of periprosthetic infections following breast reconstructions is paramount to reduce morbidity. Alpha defensin-1 (AD-1) is an antimicrobial peptide released by neutrophils. This study evaluates the relationship between quantitative AD-1 levels and infection severity in patients with suspected periprosthetic infection.

Methods:

Retrospective review was conducted of patients with prior breast implant reconstruction undergoing surgery for either suspected infection or prosthesis exchange and revision. The AD-1 level in periprosthetic fluid was sent for quantitative analysis. Association between AD-1 levels with outcomes, management, systemic markers of infection, and overall infection severity was evaluated.

Results:

Thirty-eight breasts were included. Infected breasts had higher AD-1 levels (3.91 versus 0.14, P < 0.01), greater odds of erythema [odds ratio (OR) 2.98 (1.53-5.82), P = 0.01], purulence [OR 2.84 (1.51-5.35), P = 0.01], fever [OR 1.84 (1.15-2.93), P = 0.01], threatened implant exposure [OR 2.97 (1.48-5.95), P < 0.01], and true implant exposure [OR 1.79 (1.04-3.08), P = 0.04]. Increasing AD-1 was an independent risk factor for washout (P < 0.01), and explant [OR 2.48 (1.47-4.2), P < 0.01]. AD-1 positively correlated with white blood cell count (ß = 1.81 cells/µL, P < 0.01), and serum lactate (ß = 0.19 meq/L, P < 0.04). Increasing AD-1 level was an independent predictor of infection severity (χ² = 22.77, P < 0.01).

Conclusions:

AD-1 levels correlate with infection severity, highlighting its potential both when clinical examination is ambiguous and when treatment response is being monitored. Although further evaluation is warranted, AD-1 may demonstrate utility in novel breast implant salvage algorithms.

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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies / Risk_factors_studies Idioma: En Revista: Plast Reconstr Surg Glob Open Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos

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