Routine Postoperative Antibiotics After Tissue Expander Placement Postmastectomy Does Not Improve Outcome

Area of Science:

• Plastic Surgery
• Surgical Oncology
• Infectious Disease

Background:

• Postoperative antibiotics are commonly used after tissue expander breast reconstruction to prevent infections.
• Evidence is mounting to question the routine prophylactic use of these antibiotics.

Purpose of the Study:

• To compare the efficacy of prolonged postoperative antibiotics versus perioperative-only antibiotics for prophylaxis in immediate mastectomy reconstruction using tissue expanders.

Main Methods:

• Retrospective chart review of 529 patients undergoing immediate tissue expander placement post-mastectomy.
• Group A received perioperative antibiotics only; Group B received perioperative plus at least 7 days of oral antibiotics.
• Comparison of demographics, risk factors, and complication incidence (infection, wound issues, etc.).

Main Results:

• No significant demographic differences between the 241 patients in Group A and 288 in Group B.
• Infection incidence was 23.24% in Group A vs. 21.53% in Group B (P=0.412).
• Other complication rates showed similar trends between groups.

Conclusions:

• Routine use of postoperative antibiotics following tissue expander placement for immediate mastectomy reconstruction does not decrease complication rates.
• Clinical outcomes are not improved by extending antibiotic administration beyond the perioperative period.