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Prophylactic Antibiotics for Deep Inferior Epigastric Perforator Flap Breast Reconstruction: A Comparison between
Chih-Hsuan Changchien1,2, Chien-Liang Fang1,3, Chong-Bin Tsai4,5
1Division of Plastic and Reconstruction Surgery, Department of Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan.
Plastic and Reconstructive Surgery. Global Open
|February 27, 2023
Summary
For autologous breast reconstruction using deep inferior epigastric perforator flaps, short-term prophylactic antibiotics (24 hours) are sufficient. Extended antibiotic use did not reduce surgical site infections in this study.
Area of Science:
- Plastic Surgery
- Surgical Infection Prevention
Background:
- Consensus is lacking regarding the optimal duration of prophylactic antibiotics for autologous breast reconstruction post-mastectomy.
- Standardizing antibiotic protocols is crucial for improving patient outcomes in deep inferior epigastric perforator flap reconstructions.
Purpose of the Study:
- To evaluate the impact of varying prophylactic antibiotic durations on surgical site infection rates in patients undergoing deep inferior epigastric perforator flap breast reconstruction.
- To determine if extended antibiotic prophylaxis beyond 24 hours offers additional benefits in preventing infections.
Main Methods:
- Retrospective case series of 108 patients undergoing immediate breast reconstruction with deep inferior epigastric perforator flaps (2012-2019).
- Patients were categorized into three groups based on prophylactic antibiotic duration: 1 day, 3 days, or >7 days.
- Surgical site infection rates and relevant patient/surgical factors were analyzed.
Main Results:
- Overall surgical site infection prevalence was low (0.93% in the breast, 0% in the abdomen).
- No significant difference in surgical site infection rates was observed between groups receiving 1, 3, or >7 days of prophylactic antibiotics.
- Factors such as age, BMI, smoking, neoadjuvant chemotherapy, operation time, and drain management did not correlate with infection rates.
Conclusions:
- Prophylactic antibiotic administration beyond 24 hours is not recommended for deep inferior epigastric perforator flap breast reconstruction.
- Current findings suggest that a 24-hour antibiotic course is adequate for preventing surgical site infections in this patient population.
