Antibiotic Prophylaxis in Reduction Mammaplasty: A Network Meta-Analysis

Abstract

Background Mounting evidence suggests that breast reduction surgery displays higher rates of surgical site infections (SSI) than initially presumed. Objective of this network meta-analysis is to evaluate the effectiveness of different antibiotic regimens in the prophylaxis from surgical site infections and delayed wound healing (DWH) following breast reduction. Methods A network meta-analysis was conducted using a predetermined protocol after searching the electronic databases MEDLINE, Scopus, the Cochrane Library and US National Institutes of Health Ongoing Trials Register from inception to July 2022. The included studies had to examine breast reduction in females with at least 1-month follow-up, receiving antibiotics in an intervention arm compared to a control arm. The quality of studies was assessed using the Cochrane risk of bias tool. A frequentist Mantel-Haenszel approach was adopted for the reported SSI rates while an inverse variance random effects model was used for the DWH rates. Results A total of 10 studies was included in the analysis involving 1331 patients. All but one study controlled for major risk factors, and no differences were observed in patients’ baseline characteristics. Antibiotic administration significantly reduced the SSI rate after breast reduction, with the prolonged antibiotic regimen being the most efficacious (odds ratio [OR]: 0.36 [95%CI: 0.15–0.85]). No statistically significant reduction in delayed wound healing rate was revealed among the regimens. Conclusions Antibiotics mitigate the SSI rate after breast reduction. This meta-analysis provides an evidence-based strategy to optimize antibiotic administration. Further research is needed though to examine antibiotic prophylaxis on delayed wound healing. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Laser-Assisted Drug Delivery on the Face: A Systematic Review of Indications and Outcomes

“…The current era of evidence-based medicine is characterized by better medical and surgical outcomes based on the accumulated data from well-conducted trials, systematic reviews, and meta-analyses of these studies [20][21][22]. This evidence has a direct impact on the quality and safety of the provided treatments and also on patient recovery and satisfaction [23][24][25]. Based on these principles, we aimed to summarize and comprehensively evaluate the efficacy and safety of laser-assisted drug delivery in various non-oncological facial applications.…”

The Association of Vitamin D with Non-Melanoma Skin Cancer Risk: An Umbrella Review of Systematic Reviews and Meta-Analyses

“…Network meta-analyses and umbrella reviews present the most recent advances in the era of evidence-based medicine, enabling the analysis and synthesis of the best data available on a complicated research question, while highlighting questions to be further explored [52,53]. This overview is the first attempt to synthesize all relevant evidence on the effects of VitD on NMSC incidence.…”