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Postoperative Antibiotic Prophylaxis in Reduction Mammaplasty: A Randomized Controlled Trial.
Edgard S Garcia1, Daniela F Veiga1, Joel Veiga-Filho1
1From the Graduate Program in Translational Surgery, Universidade Federal de São Paulo; the Division of Plastic Surgery and the Department of Bioestatistics, Universidade do Vale do Sapucaí; and Universidade de Santo.
Postoperative antibiotic prophylaxis did not significantly impact surgical-site infection rates in reduction mammaplasty patients. This study found no difference in infection rates between groups receiving antibiotics and those receiving a placebo after the procedure.
Area of Science:
- Plastic Surgery
- Infectious Disease Prevention
- Surgical Site Infections
Background:
- Reduction mammaplasty is a common procedure.
- Antibiotic use in reduction mammaplasty has shown benefits, but evidence for postoperative prophylaxis is lacking.
- This study investigates the impact of postoperative antibiotics on infection rates.
Purpose of the Study:
- To evaluate the influence of postoperative antibiotic delivery on surgical-site infection (SSI) rates following reduction mammaplasty.
- To determine if continued antibiotic prophylaxis beyond initial intraoperative doses affects infection outcomes.
- To provide evidence-based guidance on the necessity of postoperative antibiotics in this patient population.
Main Methods:
- A triple-blind, randomized noninferiority trial involving 124 women undergoing reduction mammaplasty.
- Patients received standard intraoperative antibiotics and were then randomized to receive either 7 days of postoperative cephalexin or a placebo.
- Surgical-site infections were assessed weekly for 4 weeks using CDC criteria.
Main Results:
- The overall surgical-site infection rate was low at 0.81%.
- No statistically significant difference in infection rates was observed between the antibiotic and placebo groups (p = 1.00).
- A trend towards longer surgery time was noted in the placebo group, though not the primary outcome.
Conclusions:
- Postoperative antibiotic prophylaxis does not appear to influence surgical-site infection rates in reduction mammaplasty.
- The findings suggest that routine postoperative antibiotic use may not be necessary for this procedure.
- Further research could explore specific patient subgroups or alternative prophylactic strategies.
