Skip to main content
Erschienen in: Aesthetic Plastic Surgery 5/2022

10.05.2022 | Original Article

Antibiotic Prophylaxis in Reduction Mammaplasty: A National Survey

verfasst von: Ricardo Beckhauser Kuhnen, Miguel Sabino Neto, Lucas Vassalli Souza, Lydia Masako Ferreira, Daniela Francescato Veiga

Erschienen in: Aesthetic Plastic Surgery | Ausgabe 5/2022

Einloggen, um Zugang zu erhalten

Abstract

Background

Although there is limited evidence for regulating the use of prophylactic antibiotics in reduction mammaplasty, many plastic surgeons prescribe them, even in the postoperative period. This study aimed to conduct a national survey to investigate the antibiotic prophylaxis protocols followed by Brazilian plastic surgeons in reduction mammaplasty.

Methods

An anonymous survey comprising 19 questions was sent to all 4864 active members of the Brazilian Society of Plastic Surgery (SBCP). The surgeons electronically received the invitation to participate in the survey and the link to fill out the electronic form.

Results

In total, 859 surgeons (17.7%) responded. Most respondents (77.8%) were men and aged 35–55 years (61.5%); 58.6% of them had 10–29 years of specialty training. Only a minor proportion of the respondents (0.5%) reported not prescribing antibiotics at any time (95% confidence interval [CI]: 0.0–0.9), 9.9% (95% CI: 7.9–11.9) prescribed them only preoperatively, and 14.6% (95% CI: 12.2–16.9) prescribed continued antibiotic use for 24 h. The majority of the respondents (75.1%; 95% CI: 72.1–77.9) prescribed antibiotics for additional days after discharge. There were significant associations between antibiotic prescription and the surgeons’ age group (p = 0.015), time since graduation (p < 0.001), experience in the specialty practice (p = 0.003), SBCP membership (p < 0.001), and surgical site infection rates (p = 0.011).

Conclusion

Most responding plastic surgeons affirmed that they prescribed prophylactic antibiotics for more than 24 h in reduction mammaplasty cases.

Level of Evidence V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
Literatur
2.
Zurück zum Zitat Zapata-Copete J, Aguilera-Mosquera S, García-Perdomo HA (2017) Antibiotic prophylaxis in breast reduction surgery: a systematic review and meta-analysis. J Plast Reconstr Aesthet Surg 70:1689–1695CrossRef Zapata-Copete J, Aguilera-Mosquera S, García-Perdomo HA (2017) Antibiotic prophylaxis in breast reduction surgery: a systematic review and meta-analysis. J Plast Reconstr Aesthet Surg 70:1689–1695CrossRef
3.
Zurück zum Zitat Vieira LFDF, De Melo Neto AF, Schio MR, De Oliveira JAV, Almeida CLA, Ferraz AAB (2016) Controversies in reduction mammoplasty: Being a “clean” operation, does it mandate antibiotic prophylaxis? Surg Infect 17:596–600CrossRef Vieira LFDF, De Melo Neto AF, Schio MR, De Oliveira JAV, Almeida CLA, Ferraz AAB (2016) Controversies in reduction mammoplasty: Being a “clean” operation, does it mandate antibiotic prophylaxis? Surg Infect 17:596–600CrossRef
4.
Zurück zum Zitat Vazquez-Aragon P, Lizan-Garcia M, Cascales-Sanchez P, Villar-Canovas MT, Garcia-Olmo D (2003) Nosocomial infection and related risk factors in a general surgery service: a prospective study. J Infect 46:17–22CrossRef Vazquez-Aragon P, Lizan-Garcia M, Cascales-Sanchez P, Villar-Canovas MT, Garcia-Olmo D (2003) Nosocomial infection and related risk factors in a general surgery service: a prospective study. J Infect 46:17–22CrossRef
5.
Zurück zum Zitat Bartsich S, Ascherman JA, Whittier S, Yao CA, Rohde C (2011) The breast: a clean-contaminated surgical site. Aesthet Surg J 31:802–806CrossRef Bartsich S, Ascherman JA, Whittier S, Yao CA, Rohde C (2011) The breast: a clean-contaminated surgical site. Aesthet Surg J 31:802–806CrossRef
6.
Zurück zum Zitat Ahmadi AH, Cohen BE, Shayani P (2005) A prospective study of antibiotic efficacy in preventing infection in reduction mammaplasty. Plast Reconst Surg 116:126–131CrossRef Ahmadi AH, Cohen BE, Shayani P (2005) A prospective study of antibiotic efficacy in preventing infection in reduction mammaplasty. Plast Reconst Surg 116:126–131CrossRef
7.
Zurück zum Zitat Veiga-Filho J, Veiga DF, Neto MS, Amorim MC, Novo NF, Ferreira LM (2010) The role of antibiotics in reduction mammaplasty. Ann Plast Surg 65:144–146CrossRef Veiga-Filho J, Veiga DF, Neto MS, Amorim MC, Novo NF, Ferreira LM (2010) The role of antibiotics in reduction mammaplasty. Ann Plast Surg 65:144–146CrossRef
8.
Zurück zum Zitat Shortt R, Cooper MJ, Farrokhyar F, Bain J (2014) Meta-analysis of antibiotic prophylaxis in breast reduction surgery. Plast Surg 22:91–94CrossRef Shortt R, Cooper MJ, Farrokhyar F, Bain J (2014) Meta-analysis of antibiotic prophylaxis in breast reduction surgery. Plast Surg 22:91–94CrossRef
9.
Zurück zum Zitat Berríos-Torres SI, Umscheid CA, Bratzler DW, Leas B, Stone EC, Kelz RR, Reinke CE, Morgan S, Solomkin JS, Mazuski JE, Dellinger EP, Itani KMF, Berbari EF, Segreti J, Parvizi J, Blanchard J, Allen G, Kluytmans JAJW, Donlan R, Schecter WP, Committee HICPA (2017) Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg 152:784CrossRef Berríos-Torres SI, Umscheid CA, Bratzler DW, Leas B, Stone EC, Kelz RR, Reinke CE, Morgan S, Solomkin JS, Mazuski JE, Dellinger EP, Itani KMF, Berbari EF, Segreti J, Parvizi J, Blanchard J, Allen G, Kluytmans JAJW, Donlan R, Schecter WP, Committee HICPA (2017) Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg 152:784CrossRef
10.
Zurück zum Zitat Kalliainen LK (2012) ASPS clinical practice guideline summary on reduction mammaplasty. Plast Reconstr Surg 130:785–789CrossRef Kalliainen LK (2012) ASPS clinical practice guideline summary on reduction mammaplasty. Plast Reconstr Surg 130:785–789CrossRef
11.
Zurück zum Zitat Hardwicke JT, Bechar J, Skillman JM (2013) Are systemic antibiotics indicated in aesthetic breast surgery? A systematic review of the literature. Plast Reconstr Surg 131:1395–1403CrossRef Hardwicke JT, Bechar J, Skillman JM (2013) Are systemic antibiotics indicated in aesthetic breast surgery? A systematic review of the literature. Plast Reconstr Surg 131:1395–1403CrossRef
12.
Zurück zum Zitat Lundberg J, Thorarinsson A, Elander A, Lidén M, Lewin R, Göransson M (2013) Risk factors for complications after breast reduction surgery. J Plast Surg Hand Surg 48:10–14PubMed Lundberg J, Thorarinsson A, Elander A, Lidén M, Lewin R, Göransson M (2013) Risk factors for complications after breast reduction surgery. J Plast Surg Hand Surg 48:10–14PubMed
13.
Zurück zum Zitat Veiga DF, da Silva GE, Moreira-Filho JW, de Mattos Andrade EB, Juliano Y, Veiga-Filho J, Ferreira LM (2020) Single dose versus 24 h antibiotic prophylaxis in reduction mammaplasty: study protocol for a randomized controlled trial. Trials 21:1–9CrossRef Veiga DF, da Silva GE, Moreira-Filho JW, de Mattos Andrade EB, Juliano Y, Veiga-Filho J, Ferreira LM (2020) Single dose versus 24 h antibiotic prophylaxis in reduction mammaplasty: study protocol for a randomized controlled trial. Trials 21:1–9CrossRef
14.
Zurück zum Zitat Boccara D, Couteau C, Chaouat M, Mimoun M, Serror K (2018) Antibiotic prophylaxis in breast reduction surgery: a different approach. J Plast Reconstr Aesthet Surg 71:435–436CrossRef Boccara D, Couteau C, Chaouat M, Mimoun M, Serror K (2018) Antibiotic prophylaxis in breast reduction surgery: a different approach. J Plast Reconstr Aesthet Surg 71:435–436CrossRef
15.
Zurück zum Zitat Liu DZ, Dubbins JA, Louie O, Said HK, Neligan PC, Mathes DW (2012) Duration of antibiotics after microsurgical breast reconstruction does not change surgical infection rate. Plast Reconstr Surg 129:362–367CrossRef Liu DZ, Dubbins JA, Louie O, Said HK, Neligan PC, Mathes DW (2012) Duration of antibiotics after microsurgical breast reconstruction does not change surgical infection rate. Plast Reconstr Surg 129:362–367CrossRef
16.
Zurück zum Zitat Sajid MS, Hutson K, Akhter N, Kalra L, Rapisarda IF, Bonomi R (2012) An updated meta-analysis on the effectiveness of preoperative prophylactic antibiotics in patients undergoing breast surgical procedures. Breast J 18:312–317CrossRef Sajid MS, Hutson K, Akhter N, Kalra L, Rapisarda IF, Bonomi R (2012) An updated meta-analysis on the effectiveness of preoperative prophylactic antibiotics in patients undergoing breast surgical procedures. Breast J 18:312–317CrossRef
17.
Zurück zum Zitat Kerrigan CL, Slezak SS (2013) Evidence-based medicine: reduction mammaplasty. Plast Reconstr Surg 132:1670–1683CrossRef Kerrigan CL, Slezak SS (2013) Evidence-based medicine: reduction mammaplasty. Plast Reconstr Surg 132:1670–1683CrossRef
18.
Zurück zum Zitat Greco R, Noone B (2017) Evidence-based medicine: reduction mammaplasty. Plast Reconstr Surg 139:230e–239eCrossRef Greco R, Noone B (2017) Evidence-based medicine: reduction mammaplasty. Plast Reconstr Surg 139:230e–239eCrossRef
19.
Zurück zum Zitat Clayton JL, Bazakas A, Lee CN, Hultman CS, Halvorson EG (2012) Once is not enough: withholding postoperative prophylactic antibiotics in prosthetic breast reconstruction is associated with an increased risk of infection. Plast Reconstr Surg 130:495–502CrossRef Clayton JL, Bazakas A, Lee CN, Hultman CS, Halvorson EG (2012) Once is not enough: withholding postoperative prophylactic antibiotics in prosthetic breast reconstruction is associated with an increased risk of infection. Plast Reconstr Surg 130:495–502CrossRef
20.
Zurück zum Zitat Crawford CB, Clay JA, Seydel AS, Wernberg JA (2016) Surgical site infections in breast surgery: the use of preoperative antibiotics for elective, nonreconstructive procedures. Int J Breast Cancer 2016:1–7CrossRef Crawford CB, Clay JA, Seydel AS, Wernberg JA (2016) Surgical site infections in breast surgery: the use of preoperative antibiotics for elective, nonreconstructive procedures. Int J Breast Cancer 2016:1–7CrossRef
21.
Zurück zum Zitat Garcia ES, Veiga DF, Veiga-Filho J, Cabral IV, Pinto NLL, Novo NF, Sabino-Neto M, Ferreira LM (2020) Postoperative antibiotic prophylaxis in reduction mammaplasty: a randomized controlled trial. Plast Reconstr Surg 145(6):1022e–1028eCrossRef Garcia ES, Veiga DF, Veiga-Filho J, Cabral IV, Pinto NLL, Novo NF, Sabino-Neto M, Ferreira LM (2020) Postoperative antibiotic prophylaxis in reduction mammaplasty: a randomized controlled trial. Plast Reconstr Surg 145(6):1022e–1028eCrossRef
22.
Zurück zum Zitat Okoro SA, Barone C, Bohnenblust M, Wang HT (2008) Breast reduction trend among plastic surgeons: a national survey. Plast Reconstr Surg 122:1312–1320CrossRef Okoro SA, Barone C, Bohnenblust M, Wang HT (2008) Breast reduction trend among plastic surgeons: a national survey. Plast Reconstr Surg 122:1312–1320CrossRef
23.
Zurück zum Zitat Peled IJ, Dvir G, Berger J, Ramon I, Ullmann Y, Nachlieli T (2000) Prophylactic antibiotics in aesthetic and reconstructive surgery. Aesth Plast Surg 24:299–302CrossRef Peled IJ, Dvir G, Berger J, Ramon I, Ullmann Y, Nachlieli T (2000) Prophylactic antibiotics in aesthetic and reconstructive surgery. Aesth Plast Surg 24:299–302CrossRef
24.
Zurück zum Zitat Iwuagwu OC, Platt AJ, Drew PJ (2006) Breast reduction surgery in the UK and Ireland—current trends. Ann R Coll Surg Engl 88:585–588CrossRef Iwuagwu OC, Platt AJ, Drew PJ (2006) Breast reduction surgery in the UK and Ireland—current trends. Ann R Coll Surg Engl 88:585–588CrossRef
25.
Zurück zum Zitat Young PY, Khadaroo RG (2014) Surgical site infections. Surg Clin North Am 94:1245–1264CrossRef Young PY, Khadaroo RG (2014) Surgical site infections. Surg Clin North Am 94:1245–1264CrossRef
26.
Zurück zum Zitat Ariyan S, Martin J, Lal A, Cheng D, Borah GL, Chung KC, Conly J, Havlik R, Lee WPA, McGrath MH, Pribaz J, Young VL (2015) Antibiotic prophylaxis for preventing surgical-site infection in plastic surgery: an evidence-based consensus conference statement from the American Association of Plastic Surgeons. Plast Reconstr Surg 135:1723–1739CrossRef Ariyan S, Martin J, Lal A, Cheng D, Borah GL, Chung KC, Conly J, Havlik R, Lee WPA, McGrath MH, Pribaz J, Young VL (2015) Antibiotic prophylaxis for preventing surgical-site infection in plastic surgery: an evidence-based consensus conference statement from the American Association of Plastic Surgeons. Plast Reconstr Surg 135:1723–1739CrossRef
27.
Zurück zum Zitat DeBono R (1998) Problem encountered in a questionnaire-based study intended to investigate the use of prophylactic antibiotics by plastic surgeons in the UK. Br J Plast Surg 51:569PubMed DeBono R (1998) Problem encountered in a questionnaire-based study intended to investigate the use of prophylactic antibiotics by plastic surgeons in the UK. Br J Plast Surg 51:569PubMed
Metadaten
Titel
Antibiotic Prophylaxis in Reduction Mammaplasty: A National Survey
verfasst von
Ricardo Beckhauser Kuhnen
Miguel Sabino Neto
Lucas Vassalli Souza
Lydia Masako Ferreira
Daniela Francescato Veiga
Publikationsdatum
10.05.2022
Verlag
Springer US
Erschienen in
Aesthetic Plastic Surgery / Ausgabe 5/2022
Print ISSN: 0364-216X
Elektronische ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-022-02903-w

Weitere Artikel der Ausgabe 5/2022

Aesthetic Plastic Surgery 5/2022 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.