2020 Volume 1 Issue 3 Pages 130-132
Although abdominal flaps are commonly used in breast reconstruction surgery, donor site infections are often difficult to treat because of the large area of the affected region. In our practice, we begin continuous irrigation at an early stage for treatment-resistant cases. Between July 2013 and December 2019, four out of 180 patients (2.2%), who underwent breast reconstruction with free deep inferior epigastric perforator flaps at our institution, experienced antibiotic-resistant infections in the donor site. The wounds were scraped and cleaned, and a continuous irrigation system was placed under general anesthesia. For the washing protocol, continuous irrigation was performed with 1,000 ml/day physiological saline, which included one dose of the antibiotic per day, for 5 days postoperatively. Once white blood cell counts returned to preoperative levels, continuous irrigation was stopped. The irrigation system and drain were removed once drain volume reached <30 mL/day; antibiotics were also stopped. Infections subsided in all four patients, and they were discharged at a mean of 8.8 days (range, 7-12 days) after reoperation. While our continuous irrigation method requires general anesthesia, it does not require postoperative wound treatment, resulting in less pain, a shorter wound healing period, and better cosmetic results.
