Preoperative Octenisan® application in the reduction of breast implant infection

Introduction:

Postoperative infection in implant-based reconstructive breast surgery is a common problem. Analogous to a method used in orthopedic surgery, preoperative application of a disinfecting washing agent may reduce postoperative infection rates. This retrospective analysis evaluated whether preoperative Octenisan® (Schülke & Mayr GmbH, Norderstedt, Germany) application yields a reduction in postoperative complication/infection rates in breast reconstructive surgery.

Methods:

Between 2016 and 2019, 200 patients were treated with implant-based breast reconstruction plus Octenisan® washing lotion at the municipal hospital of Cologne, Holweide, Germany. The washing agent was applied for five days prior to breast reconstructive surgery. Patient recruitment was consecutive. Patient cohorts were divided into patients who applied Octenisan® and patients who did not. Thus, patient adherence to the Octenisan® application regimen was recorded. Endpoints included major complication rates (i.e. revision surgery, implant loss) and minor complications i.e. seroma requiring aspiration, infection requiring antibiotics, red breast syndrome and wound dehiscence.

Results:

Major complication rates did not differ significantly. There was no difference in implant loss rates. We were not able to show a significant benefit of administering Octenisan® prior to surgery. Interestingly, patient adherence to the application regimen was only 50.4%.

Conclusions:

Although preoperative washing protocols involving Octenisan® are being implemented in other surgical fields, we did not find a reduction in implant infection rates. Nonetheless, the product seems safe to use in a breast reconstructive setting.