Suction drains in esthetic breast implant exchange are associated with surgical site infections: A retrospective cohort study.

[BACKGROUND AND OBJECTIVE] Surgical site infection (SSI) following esthetic breast implant exchange occurs in up to 2% of procedures. The effect of suction drains on SSI risk in these cases remains controversial. This study aimed to assess the SSI risk in the presence of suction drains after esthetic exchange of breast implants.

[METHODS] This is a retrospective cohort study of patients undergoing esthetic breast implant exchange between 2012 and 2015. SSI was determined according to the definition of the Center for Disease Control and Prevention. Multivariate analysis using a logistic regression model to identify independent risk factors for SSI was performed.

[RESULTS] A total of 256 women (504 breasts) met the inclusion criteria and were included in the study. The mean age was 44 ± 11 years. The mean operative time was 93 ± 40 min. The mean implant age at the time of the exchange was 10.3 ± 6.5 years. Suction drains were used in 229 breasts (45.4%) and were removed after 6 ± 7 days. Twenty (4%) breasts were diagnosed with SSI, of which 17 had suction drains. Suction drain use and days until drain removal were associated with a higher risk of SSI (85.0% vs. 43.8%, p < 0.001; 6.97 days vs. 12.07 days, p < 0.001, respectively). The use of suction drains remained an independent risk factor for SSI after adjustment for age, smoking, and previous capsular contracture (OR = 10.66, CI 95% 2.42-46.82).

[CONCLUSIONS] Suction drain use in esthetic breast implant exchange is associated with an increased risk of SSI. Surgeons should carefully consider using suction drains in selected cases only.