Document Detail


Are systemic antibiotics indicated in aesthetic breast surgery? A systematic review of the literature.
MedLine Citation:
PMID:  23416440     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The use of systemic prophylactic antibiotics to reduce surgical-site infection in aesthetic breast surgery remains controversial. The aim of this review is to weigh the available evidence with respect to reducing surgical-site infection.
METHODS: Two literature searches were performed to analyze the available data for studies involving either reduction or augmentation mammaplasty and the results of different antibiotics regimens. Outcome measures included surgical-site infection and capsular contracture.
RESULTS: A total of 2971 patients (5891 breasts) were included. A meta-analysis of surgical-site infection incidence after aesthetic breast surgery revealed a significant reduction in infections overall with antibiotic prophylaxis compared with controls (p=0.02). This was most significant with a single preoperative antibiotic dose (p=0.02). In cases of reduction mammaplasty, when antibiotics are administered as a single preoperative dose, the risk of developing surgical-site infection is halved. With augmentation mammaplasty, there was no effect on infection rates with any antibiotic regimen. Data concerning the incidence of capsular contracture were insufficient for meta-analysis.
CONCLUSIONS: For cases of reduction mammaplasty, the authors recommend a single intravenous perioperative dose of antibiotic with action against Staphylococcus species. For augmentation mammaplasty, there is no evidence to refute current guidelines, based on recommendations obtained from other forms of implant surgery.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
Authors:
Joseph T Hardwicke; Janak Bechar; Joanna M Skillman
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  131     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-05-29     Completed Date:  2013-08-02     Revised Date:  2014-02-10    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1395-403     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Antibiotic Prophylaxis*
Breast Implantation*
Controlled Clinical Trials as Topic
Cross-Sectional Studies
Evidence-Based Medicine
Female
Humans
Infusions, Intravenous
Mammaplasty*
Randomized Controlled Trials as Topic
Staphylococcal Infections / epidemiology,  prevention & control*
Surgical Wound Infection / epidemiology,  prevention & control*
Comments/Corrections
Comment In:
Plast Reconstr Surg. 2014 Jan;133(1):62e-3e   [PMID:  24374693 ]
Plast Reconstr Surg. 2014 Jan;133(1):63e-4e   [PMID:  24374694 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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