Research Information System
Turkish Journal of Plastic Surgery, vol.33, no.3, pp.117-124, 2025 (ESCI, Scopus)
Breast implant surgery, particularly in reconstructive cases following mastectomy, carries a significant risk of infection and capsular contracture (CC). The use of antimicrobial irrigation solutions is a widely adopted strategy to minimize these complications, yet the optimal solution remains debated. This review examines the efficacy, safety, and clinical implications of different antimicrobial irrigation solutions in both reconstructive and esthetic breast surgeries. A comprehensive literature search was conducted using PubMed, Scopus, and Web of Science to identify relevant studies assessing infection prevention and CC reduction. Studies were selected based on relevance, study design, and reported clinical outcomes. The findings suggest that triple antibiotic solution (TAS) is highly effective for infection control, particularly in high-risk reconstructive cases, though concerns about antibiotic resistance persist. Povidone-iodine is widely used, demonstrating efficacy but raising concerns about implant integrity. Chlorhexidine also shows potential; however, inconsistent findings limit definitive conclusions. In esthetic breast augmentation, where infection rates are generally lower, proper irrigation protocols remain essential. Some studies report comparable efficacy between TAS, chlorhexidine, and povidone-iodine, while others highlight differences in long-term outcomes. The safety and cost-effectiveness of these solutions vary, with TAS being effective but costly, whereas povidone-iodine is more economical yet debated. Continuous vancomycin irrigation shows promise in reconstructive cases, yet antibiotic overuse remains a concern. Despite the widespread use of antimicrobial irrigation, no single solution is universally superior. Further high-quality, randomized studies with larger sample sizes and long-term follow-up are needed to establish standardized guidelines for optimal irrigation strategies in breast implant surgery.