203 posters, 14 topics, 5 sessions, 817 authors, 256 institutions

The AAPS 102nd Annual Meeting

May 18-21, 2024 | The Westin Copley Place, Boston, MA

P12

Alpha Defensin-1 Level Correlates With Peri-prosthetic Infection Severity Following Implant-based Breast Reconstruction

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Poster Presenter

Nikhil Sobti

Authors

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

Affiliations

The Warren Alpert Medical School of Brown University, Division of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University

Part of Topic

Aesthetic Face/Breast/Body/ Body Contouring

Alpha Defensin-1 Level Correlates with Peri-Prosthetic Infection Severity following Implant-Based Breast Reconstruction

Introduction

•Alpha-defensin-1 (AD-1) is an antimicrobial peptide released by neutrophils in response to active infection.

•Proven to be both sensitive and specific for the identification breast implant infection (qualitative).

•Quantitative analysis of AD-1 as a measure of infection severity remains lacking.

•Hypothesis: levels of AD-1 within peri-implant fluid samples correlate with degree of infection.

Methods

•Prospectively maintained database

(n = 29 patients; 38 breasts).

•Peri-prosthetic fluid was sampled, and AD-1 levels were sent for quantitative analysis.

•Control samples obtained during exchange or revision procedures.

•Modified Spear score for infection severity:

Statistical Analysis:

•Descriptive statistics of patient and management characteristics.

•Evaluation of relationship between AD-1 level and systemic signs of infection.

•Ordinal logistic regression performed to evaluate the correlation between infection severity and AD-1 level.

Results

•Total of 15 infected breasts (23 non-infected).

•Groups well-matched, except plane of reconstruction (DTI → ↑ infection rate, p < 0.01).

•Mean AD-1 Levels (>1 suggests infection):

•Infected = 3.97 (2.66-5.61)

•Non-Infected = 0.12 (0.08-0.16)

•Per unit increase in AD-1 correlated with clinical signs of infection.

•Clinical examination (i.e., erythema) less reliable:

Logistic regression analysis suggests that infection score rises by 1.20 for every one-unit increase in AD-1 level.

Conclusion

AD-1 levels correlate with infection severity, highlighting its potential to overcome limitations in bacterial culture and non-specific laboratory values.