Recent Antibiotic Use and Surgical Site Infections in Tissue Expander-Based Breast Reconstruction: A Propensity...

Recent antibiotic use can disrupt the human microbiota, leading to dysbiosis, which alters microbial composition and function. Despite being a clean procedure, tissue expander (TE)-based breast reconstruction is associated with surgical site infection (SSI) rates as high as 30%, suggesting the influence of various factors. This study was performed to investigate whether previous antibiotic use is associated with an increased risk of SSIs in patients undergoing TE-based breast reconstruction.

The TriNetX database was queried to identify patients who underwent TE-based breast reconstruction. Patients were classified into an exposed group, who received antibiotics within 30 days before surgery, and a control group, who did not. Propensity score matching was performed for infection risk factors. The primary outcome was SSIs. Secondary outcomes included wound dehiscence, emergency department visits, antibiotic use, and TE removal. These outcomes were assessed at 30, 60, and 90 days after surgery.

After matching, each group included 1383 patients. At 30 days after surgery, patients who received antibiotics within 30 days before TE-based breast reconstruction had an increased risk of SSI (risk ratio [RR], 3.91 [ P < 0.001]), wound dehiscence (RR, 2.26 [ P = 0.002]), antibiotic use (RR, 2.38 [ P < 0.001]), and TE removal (RR, 2.05 [ P < 0.001]). These elevated risks persisted at 60 and 90 days after surgery.

Patients who used antibiotics within 30 days before TE-based breast reconstruction had an increased risk of SSIs.