Enlarged breasts can causes important physical and psychosocial discomfort. Breast reduction surgery is one of the most commonly performed cosmetic surgical procedures.
During a breast reduction there are often a number of wounds that require suturing. The breast tissue not only needs to heal in an aesthetic shape but the skin envelope and the scars on the breast need to heal appropriately in order that patients obtain the optimal outcome.
It is well known that surgical site infections will alter the healing process and can affect the quality of the scars and the final outcome. Reducing the chance of surgical infection has led many surgeons to consider the use of prophylactic antibiotics to reduce the incidence of surgical site infections in breast reduction surgery.
A recent study published in the Journal of Plastic Reconstructive and Aesthetic Surgery (Ref 1) has looked at the evidence and shown that antibiotic prophylaxis lowers the incidence of surgical site infection in breast reduction surgery.
Of 584 patients the incidence of a surgical site infection was 10.5% in those patients that were given prophylactic antibiotics compared to 18.7% in those who did not have prophylactic antibiotics.
Mr. Ross is a member of the American Society of Plastic Surgeons and a survey of 5112 plastic surgeons, who were members of the ASPS (response rate: 52%), 93% use preoperative antibiotics and 74% use additional postoperative antibiotics in this procedure (Ref 2).
Mr. Ross recommends that all patients have antibiotics as part of the perioperative journey for breast reduction surgery. Mr. Ross also recommends patients to have postoperative antibiotics. Patients do need to be aware that there are downsides to antibiotic use and need to run through the pros and cons during a consultation and make an informed decision.
References
- Zapata-Copete J, Aguilera-Mosquera S, García-Perdomo HA. Antibiotic prophylaxis in breast reduction surgery: A systematic review and meta-analysis.J Plast Reconstr Aesthet Surg. 2017 Aug 16.
- Okoro SA, Barone C, Bohnenblust M, Wang HT. Breast reduction trend among plastic surgeons: a national survey. Plast Reconstr Surg 2008;122(5):1312e20.
