Introduction: Tissue expansion/implant-based breast reconstruction is the most common breast reconstructive strategy in the United States accounting for approximately 65% of all breast reconstructions. While the procedure is generally regarded as safe, there are several associated complications including cellulitis, abscess, hematoma, and seroma. That said, it is believed that surgical face masks may provide a protective barrier between upper respiratory bacteria in surrounding personnel and a patient’s wound potentially decreasing the likelihood of infection. The purpose of this study is to understand the effects of mandatory COVID-19 masking mandates on post-mastectomy tissue expansion complications. Methods: An IRB-approved retrospective review was completed on all female patients who underwent unilateral or bilateral tissue expansion following mastectomy at our tertiary care center in 2017 (prior to the mandatory COVID-19 mask mandate) and 2021 (following the implementation of the mandate). Variables included were patient demographics, procedure information, and postoperative outcomes. Statistical analysis was performed using t-tests and chi-squared tests. Results: The analysis included 67 patients in the pre-mask mandate group and 81 patients in the post-mask mandate group. Overall, the cohort had an average age of 51 years (SD); 78% of the cohort was white, 19% black, and 3% other. There was no significant difference in age at procedure, BMI, smoking status, or history of diabetes mellitus between the two groups. Drains were used in 85% of the pre-mask mandate group and 86% of the post-mask mandate group (p=0.815). There was no difference in total drain output between the two groups (1065.85mL ± 780.85mL vs. 945.45mL ± 786.56mL; p=0.528). The post-mask mandate cohort had a significantly lower minor complication rate when compared to the pre-mask mandate cohort (25% vs. 42%; p<0.05). However, there was no significant difference in major complication rate between the pre- and post-mask mandate groups (36% vs. 27%; p=0.257). Conclusion: Despite similar demographics in our pre-mask mandate and post-mask mandate groups, there was a significantly lower rate of minor complication after the implementation of the mask mandate. A larger, more extensive retrospective review will be performed to further analyze these results.

References

Leyngold MM, Stutman RL, Khiabani KT, et al. Contributing variables to post mastectomy tissue expander infection. Breast J. 2012;18(4):351-356. doi:10.1111/j.1524-4741.2012.01253.x

Huber KM, Zemina KL, Tugertimur B, et al. Outcomes of Breast Reconstruction After Mastectomy Using Tissue Expander and Implant Reconstruction. Ann Plast Surg. 2016;76 Suppl 4:S316-S319. doi:10.1097/SAP.0000000000000675