Fine-needle aspiration for periprosthetic fluid removal after implantation of a remote internal-port tissue expander

Background: Use of internal filling ports in tissue expander–based reconstructions are advantageous because of easier self-care, lower infection rates, and fewer instances of capsule formation. The appearance of periprosthetic fluid accumulation after internal-port tissue expander implantation is a common complication that warrants treatment. In this study, we introduced a noninvasive method using fine-needle aspiration (FNA) to remove fluids accumulated after implantation of a remote internal-port tissue expander. Methods: In this study, 245 patients who underwent implantation of remote internal-port tissue expanders in our hospital from July 1, 2012, to July 1, 2019, were included and divided into two groups. In the control group, patients underwent tissue expander implantation before July 1, 2016, and large quantities of fluids were removed with surgical aspiration procedures in most cases. In the FNA group, the patients underwent implantation after July 1, 2016, and large quantities of fluids were removed first with the FNA procedure. Patients’ demographic data, indications for FNA application, and related complications were collected and analyzed. Results: Overall, 395 expanders were placed in 245 patients. Postoperative management was similar in both groups. Fluids were managed with 23 expanders in the control group and with 31 expanders in the FNA group. There was no difference in the fluid aspiration rate between the two groups. The surgical aspiration rate was 11.1% (23/208) in the control group. The success rate of FNA was 90.3% (28/31). In the FNA group, the surgical aspiration rate was 1.6% (3/187), which was significantly lower than that in the control group. There were no significant differences in complications between the two groups. Conclusion: FNA can be used for periprosthetic fluid removal after the implantation of a remote internal-port tissue expander in most cases. This method is more convenient and safer than surgical aspiration for the postoperative management of internal-port tissue expander implantation