A prospective randomized trial of perioperative cefazolin treatment in axillary and groin dissection

One hundred thirty-four patients undergoing axillary or inguinal lymph node dissection were randomized to receive perioperative treatment with either cefazolin or placebo. Risk factors for wound complications (age greater than 60 years, open wound, obesity, smoking, extremity edema, diabetes, arteriosclerotic cardiovascular disease) were recorded. The rate of complications was 36% in 97 patients (72%) with any risk factor present, compared with 14% in patients with no risk factors. Complications were seen in 30% of patients: in 14% after axillary lymph node dissection, and in 64% after inguinal lymph node dissection. The risk of complications was 23% in the group administered antibiotic treatment compared with 36% in that administered placebo treatment. This trend toward fewer complications was seen only after axillary lymph node dissection, when the rate of complications was 8% in the antibiotic-treated group compared with 20% in the placebo-treated group. After inguinal lymph node dissection, the rate of complications was 69% in the antibiotic-treated group compared with 62% in the placebo-treated group.