Abstract
BACKGROUND:: The use of acellular dermal matrix in implant-based breast reconstruction has been described for improving inferolateral prosthesis coverage and support and inframammary fold reconstruction. Recommended guidelines for infection prophylaxis are the same as for any clean procedure - antibiotic administration only before surgery. Previous studies have demonstrated increased postoperative rates of infection and seroma associated with the use of acellular dermal matrix. The authors evaluated the impact of postoperative antibiotic prophylaxis on infection rates in postmastectomy expander-based breast reconstruction with acellular dermal matrix. METHODS:: A retrospective study reviewed data of 96 patients who underwent either immediate or delayed expander-based breast reconstruction using AlloDerm allogenic acellular dermal matrix. Infection rates were analyzed after patients received postoperative antibiotic prophylaxis for at least 48 hours compared with those who received only perioperative antibiotics. RESULTS:: Infection rates for breast reconstructions with a postoperative antibiotic course were 7.9 and 3.2 percent. Patients with only perioperative antibiotics had an infection rate of 31.6 percent. Infections were defined by the endpoint of implant removal. Patient demographics, comorbidities, and intraoperative variables were recorded. Uncontrolled variables were time course between mastectomy and reconstruction, nodal dissection, operative history, and whether reconstruction was unilateral or bilateral. CONCLUSIONS:: This study demonstrates significant differences in the rate of infection between the groups of patients undergoing the first stage of two-stage implant-based breast reconstruction who received postoperative antibiotic prophylaxis and the group that received only perioperative antibiotics. This study suggests that the optimal duration of postoperative antibiotic prophylaxis is at least 48 hours. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Therapeutic, III.
| Original language | English |
|---|---|
| Pages (from-to) | 453-461 |
| Number of pages | 9 |
| Journal | Plastic and Reconstructive Surgery |
| Volume | 131 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 1 2013 |
Fingerprint
ASJC Scopus subject areas
- Surgery
Cite this
Postoperative antibiotic prophylaxis for implant-based breast reconstruction with acellular dermal Matrix. / Avashia, Yash J.; Mohan, Raja; Berhane, ChiChi; Oeltjen, John C.
In: Plastic and Reconstructive Surgery, Vol. 131, No. 3, 01.03.2013, p. 453-461.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Postoperative antibiotic prophylaxis for implant-based breast reconstruction with acellular dermal Matrix
AU - Avashia, Yash J.
AU - Mohan, Raja
AU - Berhane, ChiChi
AU - Oeltjen, John C.
PY - 2013/3/1
Y1 - 2013/3/1
N2 - BACKGROUND:: The use of acellular dermal matrix in implant-based breast reconstruction has been described for improving inferolateral prosthesis coverage and support and inframammary fold reconstruction. Recommended guidelines for infection prophylaxis are the same as for any clean procedure - antibiotic administration only before surgery. Previous studies have demonstrated increased postoperative rates of infection and seroma associated with the use of acellular dermal matrix. The authors evaluated the impact of postoperative antibiotic prophylaxis on infection rates in postmastectomy expander-based breast reconstruction with acellular dermal matrix. METHODS:: A retrospective study reviewed data of 96 patients who underwent either immediate or delayed expander-based breast reconstruction using AlloDerm allogenic acellular dermal matrix. Infection rates were analyzed after patients received postoperative antibiotic prophylaxis for at least 48 hours compared with those who received only perioperative antibiotics. RESULTS:: Infection rates for breast reconstructions with a postoperative antibiotic course were 7.9 and 3.2 percent. Patients with only perioperative antibiotics had an infection rate of 31.6 percent. Infections were defined by the endpoint of implant removal. Patient demographics, comorbidities, and intraoperative variables were recorded. Uncontrolled variables were time course between mastectomy and reconstruction, nodal dissection, operative history, and whether reconstruction was unilateral or bilateral. CONCLUSIONS:: This study demonstrates significant differences in the rate of infection between the groups of patients undergoing the first stage of two-stage implant-based breast reconstruction who received postoperative antibiotic prophylaxis and the group that received only perioperative antibiotics. This study suggests that the optimal duration of postoperative antibiotic prophylaxis is at least 48 hours. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Therapeutic, III.
AB - BACKGROUND:: The use of acellular dermal matrix in implant-based breast reconstruction has been described for improving inferolateral prosthesis coverage and support and inframammary fold reconstruction. Recommended guidelines for infection prophylaxis are the same as for any clean procedure - antibiotic administration only before surgery. Previous studies have demonstrated increased postoperative rates of infection and seroma associated with the use of acellular dermal matrix. The authors evaluated the impact of postoperative antibiotic prophylaxis on infection rates in postmastectomy expander-based breast reconstruction with acellular dermal matrix. METHODS:: A retrospective study reviewed data of 96 patients who underwent either immediate or delayed expander-based breast reconstruction using AlloDerm allogenic acellular dermal matrix. Infection rates were analyzed after patients received postoperative antibiotic prophylaxis for at least 48 hours compared with those who received only perioperative antibiotics. RESULTS:: Infection rates for breast reconstructions with a postoperative antibiotic course were 7.9 and 3.2 percent. Patients with only perioperative antibiotics had an infection rate of 31.6 percent. Infections were defined by the endpoint of implant removal. Patient demographics, comorbidities, and intraoperative variables were recorded. Uncontrolled variables were time course between mastectomy and reconstruction, nodal dissection, operative history, and whether reconstruction was unilateral or bilateral. CONCLUSIONS:: This study demonstrates significant differences in the rate of infection between the groups of patients undergoing the first stage of two-stage implant-based breast reconstruction who received postoperative antibiotic prophylaxis and the group that received only perioperative antibiotics. This study suggests that the optimal duration of postoperative antibiotic prophylaxis is at least 48 hours. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Therapeutic, III.
UR - http://www.scopus.com/inward/record.url?scp=84875027138&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84875027138&partnerID=8YFLogxK
U2 - 10.1097/PRS.0b013e31827c6d90
DO - 10.1097/PRS.0b013e31827c6d90
M3 - Article
C2 - 23446560
AN - SCOPUS:84875027138
VL - 131
SP - 453
EP - 461
JO - Plastic and Reconstructive Surgery
JF - Plastic and Reconstructive Surgery
SN - 0032-1052
IS - 3
ER -