[Preoperative antibiotic prophylaxis and breast reduction surgery: A call for new recommendations]

Although surgical site infection is one of the classic complications of breast reduction surgery, since 2024 the Société française d'anesthésie réanimation (SFAR) no longer recommends the administration of preoperative antibiotic prophylaxis. This study presents the evolution of postoperative breast infection rates in our unit according to the application of this recommendation, by comparing surgical site infection rates between homogeneous groups of patients: with and without antibiotic prophylaxis.

This was a retrospective, single-center, comparative study. All patients who underwent breast reduction surgery between January and June 2024 were included. The primary outcome was surgical site infection rate. Secondary endpoints were the usual complications of this surgery: hematoma, areolar necrosis and delayed healing.

One hundred and twenty-nine patients were included, of whom 66 received preoperative antibiotic prophylaxis (group 1) and 63 did not (group 2). Surgical site infection rates were 6.06% and 28.57% respectively in groups 1 and 2. There were significantly more surgical site infections in the group that did not receive antibiotic prophylaxis (P=0.001).

The value of antibiotic prophylaxis in breast reduction surgery is debated in numerous publications in the literature, mainly Anglo-Saxon; the great heterogeneity of protocols prevents the emergence of a consensus, whereas almost all studies show results superposable to those obtained in this series.

This study confirms the role of antibiotic prophylaxis in the reduction of surgical site infections in breast surgery, and once again highlights the absence of consensus due to the lack of high-level studies. Larger prospective studies are needed to establish appropriate recommendations.