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Controversies in Reduction Mammoplasty: Being A "Clean" Operation, Does It Mandate Antibiotic Prophylaxis?

Luiz Felipe Duarte Fernandes Vieira1, Alberto Ferraz De Melo Neto1, Marina Roggia Schio1

  • 11 Department of Plastic Surgery, Hospital Agamenon Magalhães, Recife, Pernambuco, Brazil .

Surgical Infections
|July 22, 2016
PubMed
Abstract

Insights

Prophylactic antibiotics significantly reduced surgical site infections (SSI) in reduction mammoplasty patients. This study highlights the value of antibiotic prophylaxis in preventing SSIs during breast surgery.

Area of Science:

  • Plastic Surgery
  • Infectious Disease Prevention
  • Surgical Outcomes

Background:

  • Surgical site infection (SSI) rates in breast surgery (4-18%) exceed benchmarks for clean procedures (<3.4%).
  • Reduction mammoplasty, a common breast surgery, is susceptible to SSIs.

Purpose of the Study:

  • To evaluate the incidence of SSI in reduction mammoplasty.
  • To compare SSI rates with and without antibiotic prophylaxis.
  • To determine the efficacy of antibiotic prophylaxis in this patient group.

Main Methods:

  • A randomized, double-blinded, interventional study.
  • Two groups (n=75 each): Group 1 received cefazolin prophylaxis; Group 2 (control) did not.
  • Patients were monitored for SSI up to 30 days post-operation.

Main Results:

  • 13 SSIs occurred: 3 (4.1%) in the antibiotic group vs. 10 (13.9%) in the control group (p=0.039).
  • Staphylococcus aureus was the common pathogen identified in cultures.
  • A trend suggested more SSIs with larger resections, but it was not statistically significant (p=0.051).

Conclusions:

  • Antibiotic prophylaxis significantly decreased SSI incidence in reduction mammoplasty.
  • Prophylactic antibiotics are valuable in preventing infections after breast surgery.

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