Efficacy of prophylactic antibiotics in reduction mammoplasty

The use of prophylactic antibiotics in reduction mammoplasty has been random and its efficacy unproven. This study reviewed 106 consecutive inferior pedicle technique reduction mammoplasties. Two groups were identified; 47 patients received prophylactic antibiotics and 59 patients did not. The decision of who received prophylactic antibiotics was random based on resident rotation and resident preoperative orders. The demographics were equal between the antibiotic group and the control group. The wound infection rate and the rate of delayed healing were examined in both groups. There were no statistically significant differences in the infection rate or the rate of delayed wound healing in either the antibiotic group or the control group. Individual risk factors were also studied in each group. These risk factors included obesity, older age, smoking history, and large reductions. The use of prophylactic antibiotics did not reduce the infection rate in any of these high-risk groups. Comparing the individual risk factors for the remainder of the patient population showed that the infection rate was higher in obese patients but was unaffected by prophylactic antibiotics. Delayed healing was also higher in larger reductions but also was unaffected by the use of prophylactic antibiotics. We conclude that the use of prophylactic antibiotics in reduction mammoplasty is not efficacious in reducing the rate of wound infection or delayed healing.