PURPOSE: The use of perioperative antimicrobial prophylaxis is widespread in plastic surgery when attempting to reduce the incidence of surgical site infections (SSI). Data from prospective randomized controlled trials in guiding antibiotic use is lacking. The objective of this study was to evaluate plastic surgeon prescribing habits in a tertiary university center.

METHODS AND MATERIALS: A retrospective review in one center was conducted from April to June 2006. SSI rates, and clinical outcomes with and without antimicrobial prophylaxis, were determined for all patients.

RESULTS: The cumulative SSI rate was 8,09% for 173 procedures. The SSI rate for breast surgery was 20%, with an 82,5% prescription rate. For head and neck procedures, the SSI rate was 8,3%, with 83,3% of patients receiving antibiotic prophylaxis. For hand and upper limb procedures, 62,1% of patients received antimicrobial prophylaxis, with a 1,1% SSI rate. In evaluating patients according to category A prophylaxis guidelines, inappropriate prescribing was identified in 35,0% of breast, 30,5% of head and neck, and 8,1% of hand and upper limb procedures.

CONCLUSION: This is the first study evaluating appropriateness of antimicrobial prophylaxis use by plastic surgeons. Despite widespread use of perioperative prophylactic antibiotics, significant SSI rates were still present.