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扩展抗生素预防在基于植入物的乳房重建:一个系统性审查和元分析

Chandler Hinson¹, Matthew Sink¹, Douglas Sammer¹

¹From the Department of Plastic Surgery, The University of Texas Southwestern Medical Center at Dallas, Dallas, TX.

Aesthetic surgery journal

|July 21, 2025

概括

乳房重建后长期使用预防性抗生素并没有降低感染或重新手术的发生率. 这一发现支持更短的抗生素持续时间,以减轻C. difficile感染和抗生素耐药性等风险.

科学领域:

整形外科整形外科整形外科
传染性疾病传染性疾病
手术瘤学手术瘤学

背景情况:

扩展预防性抗生素 (EPA) 疗法经常用于植入后或基于组织扩展器 (TE) 的乳房重建.
在预防感染相关并发症方面,EPA的临床益处仍然不确定.

研究的目的:

评估EPA (>48小时) 与短期抗生素治疗方案 (≤48小时) 的疗效,以减少手术部位感染 (SSIs),扩张和乳房重建后的重新手术.
为乳腺重建实践中抗生素管理提供证据.

主要方法:

按照PRISMA指南进行系统审查和元分析.
通过2025年5月搜索了四个数据库.
包括16项研究 (8,173名EPA组患者,2,676名非EPA组患者).
评估结果包括整体,轻微和重大感染,探索和重新操作率.
使用95%置信区间 (CI) 计算风险比率 (RR) 并使用Downs和Black检查清单评估研究质量.

主要成果:

对于整体感染,EPA和短期治疗方案之间没有发现统计学上显著的差异 (RR 0.90,95% CI:0.75-1.06).
对于轻微感染 (RR 0.62,95% CI:0.28-1.33),主要感染 (RR 0.83,95% CI:0.50-1.38),扩张 (RR 0.77,95% CI:0.46-1.30) 或重新手术 (RR 1.17,95% CI:0.78-1.78) 没有发现显著差异.

结论:

扩展的预防性抗生素在减少植入式乳房重建后的术后并发症方面没有提供额外的临床益处.
研究结果支持明智的,基于证据的处方,以避免长期使用抗生素的风险,如胃肠道问题和抗生素耐药性.
结果有助于标准化护理,并促进乳房重建中的抗生素管理.

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