Postoperative Antibiotic Prophylaxis in Reduction Mammaplasty: Preliminary Results of a Randomized Controlled Trial
Edgard S. Garcia, MD, MSc1, Daniela F. Veiga, MD, PhD1, Joel Veiga-Filho, MD, PhD2, Natalia L L Pinto, MD, Plastic Surgery Resident2, Isaías V. Cabral, MD2, Neil F. Novo, PhD2, Miguel Sabino-Neto, MD, PhD1, Lydia M. Ferreira, MD, PhD1.
1Federal University of Sao Paulo, São Paulo, Brazil, 2Universidade do Vale do Sapucaí, Pouso Alegre, Brazil.
Despite reduction mammaplasty is classified as a clean operation, previous studies have demonstrated that the postoperative use of antibiotics is beneficial for patients. However, there is no scientific evidence to support the use of antibiotics following reduction mammaplasty. This two-arm parallel-group randomized controlled trial was designed to assess the influence of postoperative antibiotic prophylaxis on surgical site infection (SSI) rates following reduction mammaplasty.
The calculated sample size was 62 patients per arm. We present preliminary results of 80 patients. All patients received cephalotin, 1g at the anesthetic induction and at each six hours, for the first 24 hours. Breast hypertrophy patients undergoing reduction mammaplasty were prospectively enrolled. All patients received cephalotin, 1g at the anesthetic induction and at each six hours, for the first 24 hours. At the hospital discharge, patients were randomly allocated to placebo group (n=40), which received a capsule of placebo for seven days, each six hours, or to antibiotic group (n=40), which received cephalexin, 500mg each six hours, for seven days. SSI were defined by standard criteria from the Centers for Disease Control and Prevention. Patients were assessed weekly by a blinded surgeon, for one month.
At baseline, groups were similar with regard to age (ρ=0.211), body mass index (ρ=0.218), weight of resected breast tissue (ρ=0.314) and duration of operation (ρ=0.364). None patient, in both groups, developed SSI.
These preliminary results demonstrated no differences in SSI rates between groups, suggesting that the postoperative use of antibiotics could be unnecessary.
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