Department of Plastic, Reconstructive, and Hand Surgery, Maastricht University Medical Center+, P.O. box 5800, 6202 AZ Maastricht, the Netherlands; NUTRIM School for Nutrition, and Translational Research in Metabolism, Maastricht University, P.O. Box 616, Universiteitssingel 40, 6229 ER Maastricht, the Netherlands.
Department of Plastic, Reconstructive, and Hand Surgery, Maastricht University Medical Center+, P.O. box 5800, 6202 AZ Maastricht, the Netherlands.
J Plast Reconstr Aesthet Surg. 2024 Oct;97:221-229. doi: 10.1016/j.bjps.2024.07.041. Epub 2024 Jul 25.
Autologous fat transfer (AFT) is increasingly adopted as another total breast reconstruction option. The aim of this study was to investigate the efficacy of prolonged antibiotic treatment on the onset of surgical site infections (SSIs) in patients treated with AFT for total breast reconstruction.
This retrospective cohort study was conducted on patients who received AFT for total breast reconstruction, with antibiotic prophylaxis during their (multiple) AFT procedure(s) from 9 December 2020 to 10 October 2023. Patients were divided into 2 groups according to their prophylactic antibiotic regimen. The primary outcome was analyzed, including the cumulative incidence, the relative risk (RR), the absolute risk reduction (ARR), and the number needed to treat (NNT). For the secondary outcome, a multilevel logistic regression analysis was performed.
Seven hundred sixty-five surgeries in 205 patients were analyzed. Six hundred twenty-four surgeries on 168 patients had perioperative antibiotic prophylaxis in combination with postoperative antibiotic prophylaxis administered (group 1). One hundred forty-one surgeries on 37 patients had only perioperative antibiotic prophylaxis administered (group 2). The RR was 0.68 (95% confidence interval [CI]; 0.14-3.31) of a SSI when receiving peri- and postoperative antibiotic prophylaxis in comparison with treatment with only perioperative prophylaxis. The ARR was 0.46% (95% CI; -1.40 to 2.32) with a NNT of 219 patients.
Prolonged antibiotic prophylaxis is ineffective for patients who receive total breast reconstruction with AFT. This study showed no statistically significant difference in SSIs of the reconstructed breast after receiving prolonged antibiotic treatment in comparison with single-shot perioperative antibiotic prophylaxis.
自体脂肪移植（AFT）作为另一种全乳房重建选择越来越被采用。本研究旨在调查延长抗生素治疗对接受 AFT 行全乳房重建患者手术部位感染（SSI）发生的效果。
本回顾性队列研究纳入了接受 AFT 行全乳房重建的患者，其在 2020 年 12 月 9 日至 2023 年 10 月 10 日期间的（多次）AFT 手术中接受了抗生素预防。根据预防性抗生素方案将患者分为两组。主要结局指标为分析累积发病率、相对风险（RR）、绝对风险降低（ARR）和需要治疗的人数（NNT）。次要结局指标采用多水平逻辑回归分析。
共分析了 205 例患者的 765 例手术。168 例患者的 624 例手术接受了围手术期和术后抗生素预防治疗（组 1）。37 例患者的 141 例手术仅接受了围手术期抗生素预防治疗（组 2）。与仅接受围手术期预防治疗相比，接受围手术期和术后抗生素预防治疗的患者 SSI 的 RR 为 0.68（95%置信区间[CI]：0.14-3.31）。ARR 为 0.46%（95%CI：-1.40 至 2.32），NNT 为 219 例。
对于接受 AFT 行全乳房重建的患者，延长抗生素预防无效。本研究表明，与单次围手术期抗生素预防相比，接受延长抗生素治疗的患者乳房重建后的 SSI 无统计学显著差异。
