Monday, November 4, 2002 - 4:36 PM

A Prospective Randomized Study of Antibiotic Efficacy in Preventing Infection in Reduction Mammaplasty

Ahmad H. Ahmadi, MD, Benjamin E. Cohen, MD, and Payam Shayani, MD.

A prospective randomized study of patients undergoing reduction mammaplasty was performed to establish the efficacy of prophylactic antibiotics. Fifty patients were sequentially assigned to three study limbs: no antibiotic, preoperative antibiotic only, preoperative and postoperative antibiotics. There was no significant difference (p<0.01) among the study groups for age, body mass index, history of diabetes, peripheral vascular disease, breast surgery, steroid or tobacco use, specimen weight, operative time, blood loss, intraoperative hypotension, axillary liposuction and positive intraoperative breast tissue culture. Infection was defined as cellulites, purulent drainage, infected hematoma/seroma or abscess. Delayed wound healing was defined as stitch abscess, minor dehiscence or skin necrosis. The most commonly isolated organism from breast tissue at the time of surgery was s.epidermidis (90%). There was no significant difference (p<0.01) in rate of infection among the study limbs. There was, however, a significant reduction (p<0.005) in delayed wound healing in preoperative antibiotic group. Among the studied variables only positive intraoperative culture of breast tissue was significant (p<0.008) for development of infection. Delayed wound healing also contributed to development of infection (p<0.003). This study shows that prophylactic antibiotics in reduction mammaplasty do not affect infection; however, a single preoperative dose significantly improves wound healing.
View Synopsis (.doc format, 62.0 kb)