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Prophylactic Local Antibiotic Therapy in Tissue Expander-Based Breast Reconstruction: A Systematic Review and

Hussain Salim¹, Syeda Muzna Gillani², Muhammad Talha Qureshi³

¹Dow University of Health Sciences, Karachi, Pakistan.

Aesthetic Plastic Surgery

|July 7, 2026

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This summary is machine-generated.

Prophylactic local antibiotic therapy for tissue expansion (PLATE) may reduce infections and expander loss in breast reconstruction. Further high-quality trials are needed to confirm these findings and optimize delivery methods.

Area of Science:

Plastic Surgery
Oncology
Infectious Disease

Background:

Tissue Expander-based Breast Reconstruction (TEBR) is a common post-mastectomy procedure.
Surgical site infections (SSIs) and reconstruction failure are significant complications.
Standardized guidelines and robust evidence for prophylactic local antibiotic therapy for tissue expansion (PLATE) are lacking.

Purpose of the Study:

To systematically evaluate the efficacy of PLATE in reducing SSIs and expander loss in TEBR.
To synthesize evidence from existing randomized controlled trials and observational studies.
To identify areas for future research in TEBR antibiotic prophylaxis.

Main Methods:

Systematic literature search of major databases (PubMed, Cochrane, Embase, Scopus) up to June 2025.

Keywords:

Mammaplasty Mastectomy Meta-analysis Surgical wound infection Systematic review Tissue expansion devices

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Inclusion of RCTs and observational studies reporting SSIs and expander loss.

Meta-analysis using random-effects models with heterogeneity assessment (I² statistics).

Main Results:

Eleven studies (2,570 participants) showed PLATE reduced overall infections (RR: 0.54) and expander loss (RR: 0.46).
Secondary analyses indicated potential benefits for capsular contracture and surgical infections but not wound dehiscence or necrosis.
Antibiotic delivery method may impact infection rates, but not expander loss.

Conclusions:

PLATE may reduce SSIs and expander loss in TEBR, potentially complementing systemic antibiotics.
Current evidence is largely from retrospective studies, necessitating cautious interpretation.
Larger, prospective trials are required to confirm efficacy, safety, cost-effectiveness, and optimal delivery methods, especially in high-risk patients.