Commentary on: Effectiveness of Prophylactic Antibiotics in Outpatient Plastic Surgery

Hunter, John G.

doi:10.1177/1090820x14535802

Cited by 5 publications

(2 citation statements)

References 10 publications

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“…Consequently, even though there is a dearth of clinical data, antibiotics are typically recommended for a considerable amount of time following mastectomy and rapid breast reconstruction. Infection control officers and others have criticised this technique, citing data from studies that show no commensurate decline in postoperative infection rates despite rising usage of preventive antibiotics 45 . During that period, one centre changed its approach from providing postoperative antibiotics until the drains were withdrawn to not providing postoperative prophylactic antibiotics for breast reconstruction.…”

Section: Discussionmentioning

confidence: 99%

“…Infection control officers and others have criticised this technique, citing data from studies that show no commensurate decline in postoperative infection rates despite rising usage of preventive antibiotics. 45 During that period, one centre changed its approach from providing postoperative antibiotics until the drains were withdrawn to not providing postoperative prophylactic antibiotics for breast reconstruction. They stated that there is a higher chance of infection because of this.…”

Section: Discussionmentioning

confidence: 99%

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Effect of prolonged antibiotic prophylaxis on the occurrence of surgical site wound infection after instant breast reconstruction: A meta‐analysis

Jin,

2023

International Wound Journal

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The purpose of the meta‐analysis was to evaluate and compare the effects of prolonged antibiotic prophylaxis on the occurrence of surgical site wound infection after instant breast reconstruction. The results of this meta‐analysis were analysed, and the odds ratio (OR) and mean difference with 95% confidence intervals (CIs) were calculated using dichotomous or contentious random‐ or fixed‐effect models. For the current meta‐analysis, 18 examinations spanning from 2009 to 2023 were included, encompassing 19 301 females with instant breast reconstruction. Systemic antibiotic prophylaxis had a significantly lower surgical site wound infection rate (OR, 0.85; 95% CI, 0.75–0.98, p = 0.02) compared with the standard of care after instant breast reconstruction in females. Topical antibiotic prophylaxis had a significantly lower surgical site wound infection rate (OR, 0.26; 95% CI, 0.13–0.52, p < 0.001) compared with the standard of care after instant breast reconstruction in females. The examined data revealed that systemic and topical antibiotic prophylaxis had a significantly lower surgical site wound infection rate compared with the standard of care after instant breast reconstruction in females. However, given that several examinations had a small sample size, consideration should be given to their values.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effect of prolonged antibiotic prophylaxis on the occurrence of surgical site wound infection after instant breast reconstruction: A meta‐analysis

Jin,

2023

International Wound Journal

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Reducing Surgical Site Infections in Aesthetic Surgery

Hunter

2019

Aesthetic Surgery Journal

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Extended Prophylactic Antibiotics for Mastectomy with Immediate Breast Reconstruction: A Meta-analysis

Hai

Chong

Lazar

2020

Plastic and Reconstructive Surgery - Global Open

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Background: The risk of surgical site infection (SSI) for breast surgery in patients without additional risk factors is low, below 5%. Evidence shows the risk of SSI is significantly elevated in patients undergoing immediate breast reconstruction (IBR). However, there is no consensus regarding the use of extended antibiotic prophylaxis. We aim to determine the effect of extended antibiotic prophylaxis on the incidence of SSI after IBR. Methods: PubMed and Scopus were searched by 2 independent reviewers. Data abstracted included types of study, basic characteristics, detailed antibiotic prophylaxis information, SSI event, and other secondary outcomes. We calculated the risk ratio (RR) and 95% confidence interval (CI) for each study and used a random-effects model to estimate the results. Study quality, bias, and heterogeneity were also analyzed. Results: A total of 11 studies (15,966 mastectomy procedures) were included. We found an overall 5.99% SSI rate in our population. Three studies comparing topical antibiotics with no topical antibiotics demonstrated statistical significance (RR = 0.26, 95% CI: 0.12–0.60, P = 0.001), whereas 8 studies comparing extended systemic antibiotics with standard of care found no statistical significance (RR = 0.80, 95% CI: 0.60–1.08, P = 0.13). Conclusions: In the setting of IBR following mastectomy, there is insufficient evidence for the use of extended prophylactic antibiotics to reduce SSI rates. Well-designed randomized controlled trials in patients undergoing IBR should be conducted to determine the appropriate regimen and/or duration of prophylactic antibiotics on SSI outcomes.

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Commentary on: Effectiveness of Prophylactic Antibiotics in Outpatient Plastic Surgery

Cited by 5 publications

References 10 publications

Effect of prolonged antibiotic prophylaxis on the occurrence of surgical site wound infection after instant breast reconstruction: A meta‐analysis

Effect of prolonged antibiotic prophylaxis on the occurrence of surgical site wound infection after instant breast reconstruction: A meta‐analysis

Reducing Surgical Site Infections in Aesthetic Surgery

Extended Prophylactic Antibiotics for Mastectomy with Immediate Breast Reconstruction: A Meta-analysis

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