The 14-Point Plan
Many clinicians today have adopted the “14 Point Plan” designed to help avoid the development of bacterial biofilm during breast implant surgery. Dr Konrat uses this plan for every surgery.
- 1. Provide intravenous antibiotics at the time of anaesthetic induction
- 2. Avoid peri-areolar incisions
- 3. Use nipple shields to prevent spillage of bacteria into the pocket
- 4. Perform careful atraumatic dissection to minimize obstruction of blood vessels
- 5. Perform careful hemostasis.
- 6. Avoid dissection into the breast parenchyma. The use of a dual plane, subfascial pocket has anatomic advantages
- 7. Use a dual-plane pocket or subglandular pocket
- 8. Perform pocket irrigation with correct proven triple antibiotic solution or betadine
- 9. Minimise skin-implant contamination
- 10. Minimise the time of implant opening, reposition and replacement of implant
- 11. Change surgical gloves prior to handling the implant. Use clean or new instruments that were not used in the pocket dissection
- 12. Avoid using a drainage tube, where possible
- 13. Use a layered closure
- 14. Use antibiotic prophylaxis to cover subsequent dental or surgical procedures that produce bacteraemia, and have lifelong follow-up
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