Evidence map›Paper›PMID 34297235›Full record

ArticleAnnals of surgical oncology2021

Nipple-Sparing Mastectomy: Are We Providing Proper Prophylactic Antibiotic Coverage?

Ayat ElSherif, Daniela Cocco, Sherif Armanyous, Andi Cummins, Kristina Shaffer, Eliana F R Duraes, Steven Bernard, Risal Djohan, Graham Schwarz, Chao Tu and 1 more

Abstract read
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In one paragraph

Article in Annals of surgical oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Complications, patient satisfaction, clinical outcomes, and aesthetic outcomes of nipple-sparingTranslational breast cancer research : a journal focusing on translational research in breast cancer · 2026
    Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 1 institution in 1 country.

Ayat ElSherifDivision of Breast Surgery, Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA.
Daniela CoccoDivision of Breast Surgery, Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA.
Sherif ArmanyousDivision of Breast Surgery, Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA.
Andi CumminsDepartment of Plastic and Reconstructive Surgery, Cleveland Clinic, Cleveland, OH, USA.
Kristina ShafferDivision of Breast Surgery, Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA.
Eliana F R DuraesDepartment of Plastic and Reconstructive Surgery, Cleveland Clinic, Cleveland, OH, USA.
Steven BernardDepartment of Plastic and Reconstructive Surgery, Cleveland Clinic, Cleveland, OH, USA.
Risal DjohanDepartment of Plastic and Reconstructive Surgery, Cleveland Clinic, Cleveland, OH, USA.
Graham SchwarzDepartment of Plastic and Reconstructive Surgery, Cleveland Clinic, Cleveland, OH, USA.
Chao TuDepartment of Quantitative Health, Cleveland Clinic, Cleveland, OH, USA.
Stephanie A ValenteDivision of Breast Surgery, Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA. Valents3@ccf.org.ORCID http://orcid.org/0000-0001-8601-593X
Cleveland Clinic · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInfection after nipple-sparing mastectomy (NSM) and implant-based reconstruction (IBR) can be a devastating complication. The retained nipple may act as a portal or nidus for different ductal organisms, and as such, the bacteriology of surgical-site infections (SSIs) in this setting may not be adequately covered by current antibiotic recommendations. This study sought to evaluate SSI and reconstruction outcomes in relation to antibiotic choice and identify the different microbial species implicated.

methodsA prospective database was reviewed for patients who underwent NSM with IBR from 2010 to 2019. Patient characteristics, operative details, antibiotic regimens, and subsequent treatment details were evaluated. The study analyzed SSI incidence, timing, and type of causative organisms.

resultsThe study analyzed 571 NSMs with IBR performed for 347 patients (55% with direct implants and 45% with tissue expanders). The preoperative antibiotics consisted of cephalosporin alone for 65% of the patients, a more broad single-antibiotic use for 12% of the patients, and dual-coverage antibiotics for 20% of the patients. During a median follow-up of 1.7 years, SSI developed in 12% of the reconstructions, with 6% requiring prosthesis removal. The most common SSI organism cultured was Staphylococcal species. Neither pre- nor postoperative antibiotic choice was associated with incidence of infection, type of bacteria, or need for prosthetic explanation.

conclusionFor patients undergoing NSM with IBR, a more aggressive antibiotic choice is not associated with an improved SSI rate. Patient and treatment factors continue to carry the highest risk for SSI.

Indexed as

Breast NeoplasmsMammaplastyAnti-Bacterial AgentsFemaleHumansMastectomyNipplesRetrospective StudiesAnti-Bacterial Agents

Identifiers

PMID34297235
OpenAlexW3183761281

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.