Postoperative antibiotics and infection rates after implant-based breast reconstruction: A systematic review and meta-analysis

Abstract

PurposeInfection is the most common complication following breast implant surgery. Nevertheless, the systematic administration of antibiotics after breast implant surgery has been subjected to controversial debate. In this study, we sought to elucidate the association between infection and the use of antibiotics as an aftermath of breast implantation surgical procedures.MethodsRelevant studies were identified from PubMed, Web of Science, and EMBASE search mining. The extracted data included study type, basic characteristics, administrated antibiotic information, and clinical outcomes. Random-effects models were utilized to estimate outcomes, while study quality, statistical bias, and heterogeneity were also analyzed.ResultsA total of 7 studies involving a total of 9,147 subjects were included. The results demonstrated that the use of antibiotics after breast implantation reduced the incidence of infection (risk ratio [RR]: 0.65, 95% CI, 0.46–0.90). Nevertheless, smoking, obesity and diabetes type II are risk factors for postoperative infections. Sensitivity analysis verified the robustness of the results.ConclusionsOur study identified the administration of antibiotics after breast implantation as an intervention that decreased the incidence of infection. Smoking, obesity, and diabetes type II are risk factors for postoperative infections. These findings strongly suggest that timely and effective antibiotic interventions will be crucial in future clinical practice, which may reduce the risk of postoperative infection following breast implantation.

Enhanced recovery after surgery for oncological breast surgery reduces length of stay in a resource limited setting

“…12 Post-operative antibiotic prophylaxis has also shown to lower infection risk in breast surgery, especially in the setting of implant reconstruction. 13 Similarly, tranexamic acid (TXA) has proven to reduce the occurrence of haematoma and seroma formation after breast surgery. 14 We consequently have incorporated the routine use of both in our post-operative ERAS protocols.…”

“…It has also shown to potentially improve recurrence‐free survival and overall survival in breast cancer surgery patients 12 . Post‐operative antibiotic prophylaxis has also shown to lower infection risk in breast surgery, especially in the setting of implant reconstruction 13 . Similarly, tranexamic acid (TXA) has proven to reduce the occurrence of haematoma and seroma formation after breast surgery 14 .…”

Medical Imaging of Inflammations and Infections of Breast Implants

“…Implant complications should be identified early to avoid unnecessary and costly implant changes but, above all, to avoid consequential damage and more difficult retreatments. Infection is one of the most common complications, being reported in 1.9-2.5% of breast augmentations [6] and in 4.8-35.4% of breast reconstructions [7,8]. Acute infections show the typical signs and symptoms of cellulitis, i.e., breast pain, swelling, erythema and sometimes fever, eventually pus, and can progress to toxic shock syndrome within hours after surgery [9]; therefore, the diagnosis is generally clinical.…”