Impact of Postoperative Antibiotic Prophylaxis Duration on Surgical Site Infections in Autologous Breast Reconstruction

Kerry E. Drury, Steven T. Lanier, Nima Khavanin, Keith M. Hume, Karol A. Gutowski, Brian P. Thornton, Nora M. Hansen, Robert X. Murphy, Neil A. Fine, John Y.S. Kim*

*Corresponding author for this work

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Background Although some surgeons prescribe prolonged postoperative antibiotics after autologous breast reconstruction, evidence is lacking to support this practice. We used the Tracking Operations and Outcomes for Plastic Surgeons database to evaluate the association between postoperative antibiotic duration and the rate of surgical site infection (SSI) in autologous breast reconstruction. Study Design The intervention of interest for this study was postoperative duration of antibiotic prophylaxis: either discontinued 24 hours after surgery or continued beyond 24 hours. The primary outcome variable of interest for this study was the presence of SSI within 30 days of autologous breast reconstruction. Cohort characteristics and 30-day outcomes were compared using χ2 and Fischer exact tests for categorical variables and Student t tests for continuous variables. Multivariate logistic regression was used to control for confounders. Results A total of 1036 patients met inclusion criteria for our study. Six hundred fifty-nine patients (63.6%) received antibiotics for 24 hours postoperatively, and 377 patients (36.4%) received antibiotics for greater than 24 hours. The rate of SSI did not differ significantly between patients given antibiotics for only 24 hours and those continued on antibiotics beyond the 24-hour postoperative time period (5.01% vs 2.92%, P = 0.109). Furthermore, antibiotic duration was not predictive of SSI in multivariate regression modeling. Conclusions We did not find a statistically significant difference in the rate of SSI in patients who received 24 hours of postoperative antibiotics compared to those that received antibiotics for greater than 24 hours. These findings held for both purely autologous reconstruction as well as latissimus dorsi reconstruction in conjunction with an implant. Thus, our study does not support continuation of postoperative antibiotics beyond 24 hours after autologous breast reconstruction.

Original languageEnglish (US)
Pages (from-to)174-179
Number of pages6
JournalAnnals of plastic surgery
Volume76
Issue number2
DOIs
StatePublished - Feb 1 2016

Keywords

  • TOPS
  • antibiotic
  • breast reconstruction
  • free flap
  • latissimus
  • transverse rectus abdominis myocutaneous

ASJC Scopus subject areas

  • Surgery

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