Antibiotic prophylaxis in prosthesis-based mammoplasty: A systematic review

Huang, Naisi; Liu, Mengying; Yu, Peirong; Wu, Jiong

doi:10.1016/j.ijsu.2015.01.020

Cited by 35 publications

(19 citation statements)

References 30 publications

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“…[11], Manian, [8] Viola et al [12], and Elbur et al [13] each have emphasised the increased risk of antibiotic resistance and drug-related complications such as Clostridium difficile when postoperative antibiotic prophylaxis was used after breast surgeries, due to the lack of evidence.…”

Section: Resultsmentioning

confidence: 99%

“…Vancomycin should be added to cefazolin in suspected patients or patients infected with methicillin-resistant Staphylococcus aureus (MRSA) [9]. Post-operative antibiotics have not been indicated in these guidelines however the guidelines mention the potential benefits in obese patients, patients being treated with radiation therapy or in breast reconstruction patients [3,[8][9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Peer Review #1 of "Surgical antibiotic prophylaxis use and infection prevalence in non-cosmetic breast surgery procedures at a tertiary hospital in Western Australia—a retrospective study (v0.1)"

2018

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Background. Surgical site infections (SSIs) are a common complication following breast surgery procedures, despite being considered a clean surgery. The prevalence of SSIs can be minimised with the appropriate use of antibiotic prophylaxis as outlined in the Australian Therapeutic Guidelines (eTG). The aims of this study were to evaluate adherence to the eTG for antibiotic prophylaxis in breast surgery procedures at a Western Australian teaching hospital following an update of the guidelines in 2014 and examine the impact of prophylactic antibiotics on SSI incidence and length of hospital stay. Method. A retrospective cross-sectional study which reviewed medical records from a random sample of 250 patients selected from 973 patients who underwent breast surgical procedures between February 2015 and March 2017. Results. Overall adherence to current eTG occurred in 49.2% (123/250) of operations. Pre-operative and post-operative antibiotics were prescribed in 98.4% (246/250) and 11.2% (28/250) operations respectively. Adherence rates to three specific elements of the eTG (drug prescribed, drug dosage and timing of administration) were 91.6% (2296/250), 53.6% (134/250) and 86.4% (216/250) respectively. For the 14.4% (36/250) patients with relevant drug allergies, there was zero adherence to the eTG. Overall recorded SSI prevalence was low at 5.2% (13/250). The mean length of stay in patients (2.3±1.7 days) was not influenced by level of eTG adherence (p= 0.131) or SSIs (p= 0.306). Conclusion. These data demonstrate a significant improvement in overall adherence to the eTG from 13.3% to 54.9% (p= <0.001). The level of detected SSIs in this study was low. Further improvement is necessary with respect to prescribing appropriate antibiotic dosages and for those with allergies.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Peer Review #1 of "Surgical antibiotic prophylaxis use and infection prevalence in non-cosmetic breast surgery procedures at a tertiary hospital in Western Australia—a retrospective study (v0.1)"

2018

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“…Also according to SIGN guidelines (updated 2014), in breast surgery involving implants for reconstructive or aesthetic reasons antibiotic prophylaxis is recommended[ 21 ]. Systemic reviews also recommend the use of antibiotic prophylaxis in breast implantation surgery[ 22 ][ 23 ]. In all reviewed guidelines cephalosporins are most often recommended.…”

Section: Resultsmentioning

confidence: 99%

What can we learn from sonication results of breast implants?

et al. 2017

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BackgroundDifferent research groups have identified microorganisms on breast implants by sonication with significant correlation to the rate of capsular contracture. This substantiated the hypothesis of an infectious etiology of capsular contracture. However, no clinical consequence has been drawn from these results yet. Aim of this study was to review sonication results from breast implants and to evaluate the current preoperative antibiotic regime for breast-implant surgery.MethodsWe compared breast implant sonication culture results from published reports and our own database. Current perioperative antibiotic recommendations were compared with the susceptibility profile of the found organisms.ResultsWe found Coagulase-negative staphylococci and Propionibacteria to be the main group of microorganism found by sonication on explanted breast implants. Most guidelines recommend cephalosporins for preoperative antibiotical prophylaxis for breast-implant surgery.ConclusionThere is a discrepancy between antibiotic activity of commonly used antibiotics for preoperative prophylaxis of surgical site infections, and microorganisms found by sonication on breast implants, suspected to trigger the formation of capsular contracture. A targeted antibiotic prophylaxis for breast implant surgery with glycopeptides (e.g. Vancomycin) should be considered for the prevention of capsular contracture.

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“…Antibiotic administration, drain placement, and postoperative care were not routinely discussed, despite evidence that these may influence rates of infection and capsular contracture. 31 , 32 Four studies mentioned antibiotics; half of the studies reported regular use or avoidance of drains. These considerations are particularly relevant given the evidence that non-IMF approaches are associated with increased rates of capsular contracture.…”

Section: Discussionmentioning

confidence: 99%

Asian Breast Augmentation

Zelken

Cheng

2015

Plastic and Reconstructive Surgery - Global Open

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Background:Economic, cultural, and regulatory phenomena may explain recent popularization of implant-based augmentation in Asia; but the collective Eastern experience remains limited. Asian surgeons and their patients rely on evidence-based medicine that originates elsewhere and may not be entirely relevant. Distinct anatomic and cultural features of Asian women warrant a tailored approach to breast augmentation. We explore the Asian experience with a thorough exploration of the recent literature.Methods:A literature search was performed for articles written after 2000, of Asian women who underwent augmentation mammoplasty using MEDLINE, Embase, and Pubmed Databases. Technique and outcomes data were summarized.Results:Twelve articles reported outcomes of 2089 women. Korea contributed most series (English language, 7), followed by China (3), Taiwan (1), and Japan (1). Silicone implants were used in 82.1% of women studied, and almost exclusively after 2009. More round (68.9%) than anatomic implants (31.1%) were placed. Non-inframammary (axillary, areolar, and umbilical) incisions were used in 96.9% of cases. Nearly all implants were positioned below the muscle or fascia; subglandular placement accounted for 1.1% of cases. Implant/nipple malposition (1.3%), capsular contracture (1.9%), hematoma (0.6%), and infection (0.2%) rates were reported in most series. Undesirable scarring was the most frequent complication (7.3%), but was reported only in 4 of 12 series.Conclusions:Studies of Asian women undergoing augmentation mammoplasty are limited, often with ill-defined outcomes and inadequate follow-up. As experience accumulates, an expanding literature relevant to Asian women will provide evidence-based guidelines that improve outcomes and patient satisfaction, and foster innovation.

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Antibiotic prophylaxis in prosthesis-based mammoplasty: A systematic review

Cited by 35 publications

References 30 publications

Peer Review #1 of "Surgical antibiotic prophylaxis use and infection prevalence in non-cosmetic breast surgery procedures at a tertiary hospital in Western Australia—a retrospective study (v0.1)"

Peer Review #1 of "Surgical antibiotic prophylaxis use and infection prevalence in non-cosmetic breast surgery procedures at a tertiary hospital in Western Australia—a retrospective study (v0.1)"

What can we learn from sonication results of breast implants?

Asian Breast Augmentation

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