Changchien Chih-Hsuan, Fang Chien-Liang, Tsai Chong-Bin, Hsu Chin-Hao, Yang Hsin-Yi, Chen Ming-Shan, Lin Yi-Ling
Division of Plastic and Reconstruction Surgery, Department of Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan.
Department of Medical Laboratory Science and Biotechnology, College of Medical and Health Science, Asia University, Taichung City, Taiwan.
Plast Reconstr Surg Glob Open. 2023 Feb 22;11(2):e4833. doi: 10.1097/GOX.0000000000004833. eCollection 2023 Feb.
There is no consensus on the duration of prophylactic antibiotic use for autologous breast reconstruction after mastectomy. We attempted to standardize the use of prophylactic antibiotics after mastectomy using a deep inferior epigastric perforator flap for the breast reconstruction procedure.
This retrospective case series included 108 patients who underwent immediate breast reconstruction with a deep inferior epigastric perforator flap at the Ditmanson Medical Foundation Chia-Yi Christian Hospital between 2012 and 2019. Patients were divided into three groups based on the duration of prophylactic antibiotic administration (1, 3, and >7 days) for patients with drains. Data were analyzed between January and April 2021.
The prevalence of surgical site infection in the breast was 0.93% (1/108), and in the abdomen it was 0%. The patient groups did not differ by age, body mass index, smoking status, or neoadjuvant chemotherapy. Only one patient experienced surgical site infection in the breast after half-deep necrosis of the inferior epigastric perforator flap. There were no significant differences in surgical site infection based on the duration of prophylactic antibiotic use. The operation time, methods of breast surgery, volume of fluid drainage in the first 3 days of the abdominal and breast drains, and day of removal of the abdominal and breast drains did not affect surgical site infection.
Based on these data, we do not recommend extending prophylactic antibiotics beyond 24 hours in deep inferior epigastric perforator reconstruction.
对于乳房切除术后自体乳房重建预防性使用抗生素的持续时间，目前尚无共识。我们试图通过使用腹壁下深穿支皮瓣进行乳房重建手术，来规范乳房切除术后预防性抗生素的使用。
本回顾性病例系列研究纳入了2012年至2019年期间在嘉义基督教医院 Ditmanson 医学基金会接受腹壁下深穿支皮瓣即刻乳房重建的108例患者。根据有引流管患者预防性抗生素给药的持续时间（1天、3天和>7天）将患者分为三组。于2021年1月至4月进行数据分析。
乳房手术部位感染的发生率为0.93%（1/108），腹部为0%。患者组在年龄、体重指数、吸烟状况或新辅助化疗方面无差异。仅1例患者在腹壁下深穿支皮瓣半深部坏死术后出现乳房手术部位感染。基于预防性抗生素使用的持续时间，手术部位感染无显著差异。手术时间、乳房手术方法、腹部和乳房引流管前3天的引流量以及腹部和乳房引流管的拔除日均不影响手术部位感染。
基于这些数据，我们不建议在腹壁下深穿支重建中预防性使用抗生素超过24小时。
