Effect of Perioperative Prophylactic Intravenous Antibiotic Use in Immediate Implant Based Breast Reconstruction : A Retrospective Matched Cohort Study

Abstract

Background Among breast reconstruction methods, implant-based breast reconstruction has become the mainstream. However, periprosthetic infection is still an unresolved problem. Although published articles have revealed that limited use of antibiotics is sufficient to reduce infection rates, the number of surgeons still prefer elongated usage of antibiotics is not less. The aim of our study is to validate the appropriate duration of antibiotic use to reduce infection rate after implant based breast reconstruction. Methods A retrospective study reviewed medical record of 235 patients (274 implants for reconstruction) who underwent prepectoral direct to implant breast reconstruction using acellular dermal matrix wrapping technique. Infection rates was analyzed for the patients administered postoperative prophylactic antibiotics until drain removal and those who received only 24 hours perioperative prophylactic antibiotics. Results Of the 274 implants, 98 who administered prophylactic antibiotics until drain removal had infection rate of 3.06%(3 implants) and 176 who received prophylactic antibiotics no longer than 24 hours postoperatively had infection rate of 4.49%(8 implants). Total of 11patients diagnosed with postoperative infection clinically, 8 were salvaged by antibiotic treatment, and 3 had implant removal and replacement with autologous flap. Postoperative antibiotic prophylaxis duration had no statistical significant effects in the risk of infection (P = 0.549). Conclusion The duration of prophylactic antibiotics after surgery was not related to infection risk. Further study with a large number of patients, randomized control study, route of antibiotics are needed.