Hypochlorous acid irrigation reduces the rate of infections in patients undergoing implant-based breast reconstruction.

BACKGROUND

The most common form of breast reconstruction is implant-based breast reconstruction (IBBR), accounting for approximately 81% of all such procedures. However, like all surgical procedures, IBBR has potential complications. The most notable of these complications is infection, which can occur in up to 35% of such cases. In an effort to reduce the frequency of infections in these cases, plastic surgeons are constantly evolving their techniques, including the use of various irrigation solutions to decontaminate the breast pocket at the time of surgery. One of the more novel irrigation solutions being utilized is hypochlorous acid (HOCl), a naturally occurring chemical produced by white blood cells. While there have been studies examining the antimicrobial effect of HOCl, few studies to date have addressed if the addition of HOCl irrigation with IBBR can reduce surgical infections.

METHODS

We undertook an IRB-approved, retrospective cohort study of adult female patients, aged 18 years and older, who underwent IBBR from 09/01/2021 - 06/30/2024 at our single institution. Descriptive statistics and Fisher's exact test were conducted on the dataset to derive sample characteristics and compare outcomes.

RESULTS

The study included 193 breast procedures in total. The group that did not undergo HOCl irrigation during IBBR included 38 breast with a 13% rate of infection. The group that underwent HOCl irrigation during IBBR included 155 breasts with a 3% rate of infection. The rate of infection was significantly decreased in the patients who received HOCl irrigation intra-operatively, p-value 0.026. There was no significant difference in characteristics between the 2 groups.

CONCLUSION

Our study supports the addition of HOCl irrigation to decontaminate the breast pocket during IBBR. The rate of post-operative infection rates significantly decreased after hypochlorous acid irrigation was instituted during IBBR.