Evaluation of Postoperative Infection Rates in 3084 Rhinoplasty Cases Using Antibiotic Soaks and/or Irrigations

Background: Postoperative infections after rhinoplasties are rare, yet devastating on patient outcomes. The literature reports an overall incidence of <2% with higher numbers seen in those requiring revision procedures. Materials and Methods: A retrospective chart review of rhinoplasty patients from 2002 to 2019 of the primary author (D.M.T.) was performed. The objective of this study is to demonstrate the use of postoperative antibiotic soaks and irrigations in rhinoplasty, as well as evaluate the postoperative infection rates. Results: Of the 3084 rhinoplasty procedures evaluated, there were 19 postoperative infections (infection rate [IR] = 0.62%). Patients without antibiotic soaks or irrigations had 17 infections (IR = 1.01%). The IR of antibiotic soaks was 0.08% with a significant reduction compared with no soaks/irrigations (p = 0.0053). With antibiotic soaks and irrigations, there was 1 infection (IR = 0.49%) with no significant difference between no soaks/irrigations or soaks alone. Conclusions: The use of antibiotic soaks and irrigations resulted in an IR of 0.62%. Antibiotic soaks reduced the rate of postoperative infection, particularly in secondary rhinoplasty. Antibiotic soaks and irrigations are safe, effective, and well-tolerated by patients. As a result, these techniques may be considered in patients undergoing rhinoplasty, particularly those with an extensive revision history, trauma, filler, prior infection, or underlying disease processes.