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Efficacy of antibiotic prophylaxis for reducing capsular contracture in prosthesis-based breast surgery: a systemic review and meta-analysis

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Abstract

Antibiotics Prophylaxis to prevent capsular contracture in prosthesis-based breast surgery is common in clinical practice. However, there is currently a dearth of high-quality evidence concerning the effectiveness of antibiotic usage in this field. To identify all pertinent studies prior to January 2023, a comprehensive literature search was conducted in the PubMed, Embase, Web of Science, Cochrane Library, and Medline databases. The extracted data was then subjected to meta-analysis. Fourteen studies were retained in the analysis. According to the results, perioperative antibiotic prophylaxis did not reduce the risk of capsular contracture (RR 1.15, 95% CI 0.82–1.59, p = 0.55) or surgical-site infection (RD 0.01, 95% CI − 0.01 to 0.03, p = 0.59) compared to nonantibiotic prophylaxis. There was no statistically significant difference between extended antibiotic prophylaxis and perioperative antibiotic prophylaxis in terms of preventing capsular contracture, whether calculated by patient numbers (RD 0.01, 95% CI − 0.01 to 0.02, p = 0.87) or by total procedures (RD 0.00, 95% CI − 0.00 to 0.01, p = 0.88), or controlling surgical-site infection (RR 1.05, 95% CI 0.77–1.44, p = 0.27). Additionally, topical antibiotic irrigation did not decrease the risk of infection (RR 0.61, 95% CI 0.34–1.08, p = 0.29) and capsular contracture, regardless of patient number (RR 0.41, 95% CI 0.27–0.63, p = 0.18) or total number of procedures (RR 1.29, 95% CI 0.73–2.28, p < 0.01). Current evidence revealed that both systemic and topical antibiotic prophylaxis may not provide benefits in preventing capsular contracture in prosthesis-based breast surgery. When the occurrence of surgical-site infections is minimized to the greatest extent, the administration of additional antibiotics for reducing capsular contracture should be carefully and judiciously considered.

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Funding

This work was supported by the Sichuan Science and Technology Program [Grant numbers, 2022YFS0197]; the “1.3.5” Project for Disciplines of Excellence, West China Hospital, Sichuan University (Grant no. ZYPY20003); Research fund for residents in West China Hospital, Sichuan University [YB0000005].

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  1. Pengcheng Liu, Yuting Song and Zhixing Chen have contributed equally to this work.

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  1. Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China

    Pengcheng Liu, Zhixing Chen, Zhenyu Zhang & Zhengyong Li

  2. Department of Orthopedic Surgery and Orthopedic Research Institute, Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China

    Pengcheng Liu & Yuting Song

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Liu, P., Song, Y., Chen, Z. et al. Efficacy of antibiotic prophylaxis for reducing capsular contracture in prosthesis-based breast surgery: a systemic review and meta-analysis. Updates Surg (2024). https://doi.org/10.1007/s13304-024-01767-w

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