Do Prolonged Prophylactic Antibiotics Reduce the Incidence of Surgical-Site Infections in Immediate Prosthetic Breast Reconstruction?

Wang, Frederick; Chin, Robin; Piper, Merisa; Esserman, Laura J.; Sbitany, Hani

doi:10.1097/prs.0000000000002737

Cited by 29 publications

(18 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, a recent study concluded that prolonged antibiotics use did not have a statistically significant effect on reducing surgical-site infection or implant loss. 15 More prospective randomized controlled trials are needed to determine whether prolonged prophylactic antibiotics are truly beneficial in breast reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Complications in Expander-Based Breast Reconstruction: Multivariate Analysis in Asian Patients

Suga

Shiraishi

Tsuji

et al. 2017

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Background:There have been many studies examining risk factors for complications in expander-based breast reconstruction after mastectomy, and some patient factors have been identified as risk factors. However, most of the previous studies were based on Caucasian patients.Methods:Asian patients who had a tissue expander placed for immediate breast reconstruction between January 2006 and December 2015 (363 patients and 371 expanders) were analyzed retrospectively. Univariate and multivariate analyses were performed to elucidate risk factors for complications.Results:The rate of skin necrosis was significantly higher in nipple-sparing mastectomy than in other types of mastectomies (12 patients among 107 patients, P = 0.001). The weight of the resected specimen was significantly higher in the group with complications than in the group without complications (444 g compared with 363 g, P = 0.027). Other factors (age, body mass index, smoking, expander type, preoperative chemotherapy, axillary dissection) had no significant effect on complications. Multivariate analysis with a logistic regression showed that a large breast (over 500 g) was the only significant risk factor for complications, with an odds ratio of 3.20 and a 95% confidence interval of 1.33–7.54 (P = 0.010).Conclusion:In this series of Asian patients, breast size, rather than body mass index, is the most important predictor for complications in expander-based breast reconstruction.

show abstract

Section: Discussionmentioning

confidence: 99%

Risk Factors for Complications in Expander-Based Breast Reconstruction: Multivariate Analysis in Asian Patients

Suga

Shiraishi

Tsuji

et al. 2017

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

show abstract

“…10 Pooled analysis from a systematic literature review conducted by Wang et al in 2016 concluded that the risk of surgical site infection in immediate prosthetic breast reconstruction was 1.43 times higher in patients receiving less than 24 hours of postoperative antibiotics. 11 Finally, Huang et al also concluded that extended antibiotic prophylaxis greater than 24 hours decreases the risk of SSI but could not make any conclusive statements on a specific optimal time for prophylaxis. 12…”

Section: Discussionmentioning

confidence: 99%

Antibiotic Prophylaxis in Alloplastic Breast Reconstruction: Regimens and Outcomes

et al. 2021

View full text Add to dashboard Cite

Purpose: Surgical site infections (SSI) in prosthesis-based breast reconstruction can have a significant impact on patient outcome. Despite current CDC (Centers for Disease Control and Prevention) guidelines recommending 24 hours of postoperative antibiotics, various perioperative antimicrobial regimens are reported in the literature. Consensus on the optimal duration of antibiotics remains unclear. In this study, the aim is to compare the incidence of surgical site infections following different antibiotic durations in alloplastic breast reconstruction. Methods: In this retrospective cohort study, all consecutive patients who underwent expander/implant-based breast reconstruction between January 2009 and December 2014 at a tertiary centre were included. Data on patient demographics, risk factors, operative time, choice and timing of antibiotic used before surgery, and the duration of postoperative antibiotic use were collected. The primary outcome, SSI, is defined according to CDC criteria. Results: A total of 507 consecutive expander/implant-based cases were included. Minimum follow-up time was 1 year. The overall infection incidence was 14% (95% CI: 11%-17%), and the rate of subsequent explantation was 8%. Of the infected cases, 80% (45/56) received 1 week of postoperative antibiotic, while 20% (11/56) had a prolonged course of antibiotics (2-3 weeks; P = .003, odds ratio [OR] = 2.9; 95% CI: 1.4-5.8). Most infections were superficial (65%). Prior history of radiation treatment was identified as a risk factor for developing surgical site infection ( P = .02). Conclusion: Overall infection rate and risk factors for infections are in keeping with current literature. Prescribing one week of postoperative antibiotic was found to be associated with a higher incidence of SSI compared to a more prolonged antibiotic regimen.

show abstract

“…[5] Then, this conclusion was updated by 2 recent pairwise meta-analyses, which determined that antibiotic prophylaxis was effective by simply comparing experimental and control arms [39,40] and prolonged application seemed to have no clinical benefit based on insufficient high-quality raw data. [41] However, all 4 publications failed to perform a quantitative network estimation, and their classifications of strategies lacked accurateness and meticulousness, which may not reveal the essential roles of different strategies. And these publications basically only payed attention on PRA.…”

Section: Discussionmentioning

confidence: 99%

Identifying the superior antibiotic prophylaxis strategy for breast surgery

et al. 2019

View full text Add to dashboard Cite

show abstract

Do Prolonged Prophylactic Antibiotics Reduce the Incidence of Surgical-Site Infections in Immediate Prosthetic Breast Reconstruction?

Cited by 29 publications

References 29 publications

Risk Factors for Complications in Expander-Based Breast Reconstruction: Multivariate Analysis in Asian Patients

Risk Factors for Complications in Expander-Based Breast Reconstruction: Multivariate Analysis in Asian Patients

Antibiotic Prophylaxis in Alloplastic Breast Reconstruction: Regimens and Outcomes

Identifying the superior antibiotic prophylaxis strategy for breast surgery

Contact Info

Product

Resources

About