Twenty-Hour-Hour Peri-Operative Antibiotic Prophylaxis in Tissue Expander Reconstruction: Our Ten-Year Institutional Experience. Academic Article uri icon

Overview

abstract

  • Background: Infection is a common complication after tissue expander placement. Previously, we have demonstrated that a single dose of peri-operative antibiotic agents is sufficient to achieve an adequately low infection rate for implant exchange procedures. In this follow-up study, we evaluate the efficacy of a similar course of antibiotic prophylaxis regimen for tissue expander placement procedures. Patients and Methods: This is a retrospective study of patients who underwent mastectomy and immediate tissue expander-based reconstruction from July 2011 to April 2021. The primary outcome was breast infection. Student t-test and χ2 tests were used to compare cohorts and complication rates. Multivariable regression analysis was used to identify risk factors for infection. Results: In a 10-year-period, 307 patients (529 breasts) underwent immediate tissue expander reconstruction. Infection occurred in 80 breasts (15.1%). There was no difference in infection rates across pre-pectoral, dual plane, or total submuscular approaches (p = 0.705). Once infection occurred, patients in the dual-plane cohort were more likely to be admitted for intravenous antibiotic treatment (p = 0.007). On multivariable regression analysis, mastectomy skin flap necrosis (p = 0.002), post-operative radiation therapy (p = 0.007), and active smoking (p = 0.007) were significant risk factors for subsequent infection. Conclusions: A short course of peri-operative antibiotic prophylaxis is sufficient for an adequately low infection rate. Mastectomy skin flap necrosis, post-operative radiation therapy, and active smoking placed patients at higher risk for infection. Our results advocate for the conservative use of antibiotic agents while achieving an adequate low infection rate.

publication date

  • September 13, 2022

Research

keywords

  • Breast Implants
  • Breast Neoplasms
  • Mammaplasty

Identity

Scopus Document Identifier

  • 85139570483

Digital Object Identifier (DOI)

  • 10.1089/sur.2022.153

PubMed ID

  • 36103287

Additional Document Info

volume

  • 23

issue

  • 8