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缩乳术中术后预防性使用抗生素:一项单中心回顾性队列研究

Postoperative Prophylactic Antibiotic Use in Breast Reduction Mammoplasty: A Single Centre Retrospective Cohort Study.

作者信息

Doucet Véronique M, Weirathmueller Jakob J, McLeod Graham J, Murray Kenneth A

机构信息

Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.

Section of Plastic Surgery, Department of Surgery, University of Manitoba.

出版信息

Plast Surg (Oakv). 2024 May;32(2):220-225. doi: 10.1177/22925503221107220. Epub 2022 Jun 15.

Abstract

Breast reduction mammoplasty (BRM) is a common procedure performed by plastic surgeons treating patients with hypermastia. It is customary to give preoperative prophylactic intravenous antibiotics for BRM, followed by several days of postoperative prophylactic oral antibiotics, despite the lack of evidence of their effectiveness in preventing surgical site infections (SSIs). The purpose of this study is to determine if the addition of prophylactic postoperative antibiotics is more effective in preventing SSIs in comparison to a single dose of preoperative prophylactic antibiotics in BRM. A retrospective analysis of 124 elective BRM cases by a single senior plastic surgeon was completed. Two study groups were formed based on the location of surgery and each group was assigned a different antibiotic regimen. The first antibiotic regimen consisted of a single preoperative intravenous dose of antibiotics (group 1), while the second regimen consisted of a preoperative intravenous dose followed by a 5-day course of oral antibiotics (group 2). Overall SSI rate was 5.6%. Infection rate in group 1 was 8.1% in comparison to 3.2% for group 2 ( value .44). Overall, the incidence of complications was 29.0%; 38.7% in group 1 and 19.4% in group 2 ( value .03). Complications consisted of 35 cases of delayed wound healing, 7 SSIs and 2 hematomas requiring evacuation. Study results demonstrated that the use of postoperative prophylactic antibiotics for BRM had no significant effect on the rate of SSIs.

摘要

乳房缩小整形术(BRM)是整形外科医生针对巨乳症患者实施的常见手术。尽管缺乏术前预防性静脉注射抗生素及术后数天预防性口服抗生素对预防手术部位感染(SSI)有效性的证据,但这仍是BRM的常规做法。本研究的目的是确定与单剂量术前预防性抗生素相比,术后添加预防性抗生素在预防BRM的SSI方面是否更有效。一位资深整形外科医生对124例择期BRM病例进行了回顾性分析。根据手术部位形成了两个研究组,每组采用不同的抗生素治疗方案。第一种抗生素治疗方案为术前单次静脉注射抗生素(第1组),而第二种方案为术前静脉注射一剂抗生素后,再口服5天抗生素(第2组)。总体SSI发生率为5.6%。第1组的感染率为8.1%,而第2组为3.2%(P值=0.44)。总体而言,并发症发生率为29.0%;第1组为38.7%,第2组为19.4%(P值=0.03)。并发症包括35例伤口愈合延迟、7例SSI和2例需要引流的血肿。研究结果表明,BRM术后使用预防性抗生素对SSI发生率没有显著影响。

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