Microbial growth within saline-filled tissue expanders

Background: Tissue expander based reconstruction is the most common restorative procedure used following mastectomy. Infection is a common complication in the postoperative period and may lead to failure of the reconstruction. Various previous studies have investigated the potential sources of infection during these procedures. The purpose of this study was to examine the fluid within the saline-filled tissue expander at time of implant exchange for the presence of microbial growth. Methods: Twenty-five patients (39 breasts) were enrolled in the study. Fluid samples were sent for Gram stain, aerobic, anaerobic, fungal, and acid-fast bacilli (AFB) cultures. Average age was 53.1. Mean time to exchange was 7.7 months. Average follow-up was 25 months. Results: None of the samples were positive for microbial growth at final culture (0/39). Discussion: These results show the tissue expander fluid maintains a microbial-free environment during the expansion process, and is unlikely a significant source of contamination in cases of infection. Level of evidence: Level II, prospective cohort, therapeutic study. (C) 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.