Association of Antibiotic Use and Surgical Site Infection Following Pectus Bar Removal

Surgical site infection (SSI) following pectus bar removal (PBR) is one of the most common complications despite being a clean procedure. The effect of preoperative antibiotic use on SSI rates has not been well-studied. This study aimed to evaluate the association of preoperative antibiotic use on SSIs following PBR. We hypothesized that patients who received preoperative antibiotics would have lower SSI rates.

A retrospective review was conducted of pediatric patients who underwent PBR from January 2018 to July 2023 at a single center. Patient demographic data, preoperative antibiotic administration, and a 30-d postoperative clinical course were collected. SSI was defined as a documented infection adjacent to the surgical incision requiring antibiotics or operative intervention within 30 ds of surgery.

There were 198 patients in the cohort. The majority were male (81%), with a median age of 18. Postpectus bar removal SSI was documented in 2% (4/198) of patients, with any complications occurring in 6% of the cohort. Despite being a clean case, 67% received preoperative antibiotics. There was no statistical difference between SSIs in patients who received preoperative antibiotics versus those who did not (0.8% versus 4.6%, P = 0.10).

Following PBR, close to 5% of patients had a documented SSI when antibiotics were not part of routine preoperative care. While we did not find a significant difference in SSI with antibiotic use, the incidence of SSI is higher than in other clean wound class procedures. Further efforts are needed to identify risk factors of SSI following PBR.