ArticlePlastic and reconstructive surgery2012
Once is not enough: withholding postoperative prophylactic antibiotics in prosthetic breast reconstruction is associated with an increased risk of infection.
Article in Plastic and reconstructive surgery, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it, 114 citations in OpenAlex.
- Effect of prolonged antibiotic prophylaxis on the occurrence of surgical site wound infection after instant breast reconstruction: A meta-analysis.International wound journal · 2024Pooled it
- Antibiotics and Surgical Site Infection in Expander-Based Breast Reconstruction Trial (ASSERT).Annals of surgical oncology · 2026Trial
- Effectiveness of Single vs Multiple Doses of Prophylactic Intravenous Antibiotics in Implant-Based Breast Reconstruction: A Randomized Clinical Trial.JAMA network open · 2022Trial
- Monitoring and Management of Infection following Prepectoral Implant-based Breast Reconstruction: Retrospective Analysis of Conservative Treatment Versus Implant Removal.Plastic and reconstructive surgery. Global open · 2025Article
- Validation and Recalibration of a Model for Predicting Surgical-Site Infection After Pelvic Organ Prolapse Surgery.International urogynecology journal · 2025Article
- Reducing Postbreast Reconstruction Infection Rates: Our Journey to Achieving Low Postoperative Infection Outcomes.Cureus · 2024Article
- Article
- Have We Really Shifted to an Evidence-Based Practice? A Qualitative Analysis of Primary Breast Augmentation.Eplasty · 2024Article
- Effect of Perioperative Prophylactic Intravenous Antibiotic Use in Immediate Implant-Based Breast Reconstruction: A Retrospective Matched Cohort Study.Archives of plastic surgery · 2024Article
- A prospective randomized clinical trial to assess antibiotic pocket irrigation on tissue expander breast reconstruction.Microbiology spectrum · 2023Article
- Review
- Postdischarge prophylactic antibiotics following mastectomy with and without breast reconstruction.Infection control and hospital epidemiology · 2022Article
- Final 24-hour Drain Output and Postoperative Day Are Poor Indicators for Appropriate Drain Removal.Plastic and reconstructive surgery. Global open · 2022Article
- Preventing Infection in Implant-based Breast Reconstruction: Evaluating the Evidence for Common Practices and Standardized Protocols.Plastic and reconstructive surgery. Global open · 2022Article
- Antibiotic Prophylaxis in Alloplastic Breast Reconstruction: Regimens and Outcomes.Plastic surgery (Oakville, Ont.) · 2022Article
- Postoperative antibiotics and infection rates after implant-based breast reconstruction: A systematic review and meta-analysis.Frontiers in surgery · 2022Article
- Protocol for Prevention and Monitoring of Surgical Site Infections in Implant-Based Breast Reconstruction: Preliminary Results.Medicina (Kaunas, Lithuania) · 2021Article
- Article
- Extended Prophylactic Antibiotics for Mastectomy with Immediate Breast Reconstruction: A Meta-analysis.Plastic and reconstructive surgery. Global open · 2020Article
- Current Approaches Including Novel Nano/Microtechniques to Reduce Silicone Implant-Induced Contracture with Adverse Immune Responses.International journal of molecular sciences · 2018Review
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThere has been a trend toward limiting perioperative prophylactic antibiotics, based on research not conducted in plastic surgery patients. The authors' university hospital instituted antibiotic prescribing guidelines based on the Surgical Care Improvement Project. An increased rate of surgical-site infections was noted in breast reconstruction patients. The authors sought to determine whether the change in antibiotic prophylaxis regimen affected rates of surgical-site infections.
methodsA retrospective study compared patients undergoing breast reconstruction who received preoperative and postoperative prophylactic antibiotics with a group who received only a single dose of preoperative antibiotic. Type of reconstruction and known risk factors for implant infection were noted.
resultsTwo hundred fifty patients were included: 116 in the pre-Surgical Care Improvement Project group and 134 in the Surgical Care Improvement Project group. The overall rate of surgical-site infections increased from 18.1 percent to 34.3 percent (p = 0.004). Infections requiring reoperation increased from 4.3 percent to 16.4 percent (p = 0.002). Multivariate logistic regression demonstrated that patients in the Surgical Care Improvement group were 4.74 times more likely to develop a surgical-site infection requiring reoperation (95 percent CI, 1.69 to 13.80). Obesity, history of radiation therapy, and reconstruction with tissue expanders were associated with increased rates of surgical-site infection requiring reoperation.
conclusionsWithholding postoperative prophylactic antibiotics in prosthetic breast reconstruction is associated with an increased risk of surgical-site infection, reoperation, and thus reconstructive failure. The optimal duration of postoperative prophylactic antibiotic use is the subject of future study.
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