Antibiotic prophylaxis: current recommendations in plastic surgery
- 8 Downloads
Guidelines for prophylactic antibiotics in surgery have long been established; however, few have focused on recommendations in plastic surgery. Surgical site infection rates remain low, yet the use of prophylactic antibiotics has surged in the past 30 years. This article summarizes current recommendations of prophylactic antibiotic use to produce consensus guidelines in plastic surgery.
A literature review was conducted in the PubMed, Cochrane, and Ovid databases and studies were included if randomized controlled trials indicated a statistically significant decrease in surgical site infections. Surveys conducted by the American Society of Plastic Surgeons regarding prophylactic antibiotic use from 1975, 1985, 2000, and 2010 were compiled and analyzed.
Of 143 articles found, nine randomized controlled trials showed a reduction in surgical site infections after antibiotic prophylaxis for specific plastic surgery procedures. There are evidence-based recommendations for prophylactic antibiotics in breast surgery, abdominoplasty, contaminated hand or face surgery, prosthetic surgery, rhinoplasty, microsurgery, and acute and burn reconstruction cases. The proportion of plastic surgeons using prophylactic antibiotics has steadily increased from 1975 to 2010 with a significant increase from 2000 to 2010.
Systemic antibiotic prophylaxis is recommended for use in breast surgery, abdominoplasty, contaminated hand or face surgery, prosthetic surgery, rhinoplasty, microsurgery, and acute and burn reconstruction cases. Recent surveys indicate that the majority of plastic surgeons continue to use prophylactic antibiotics in clean cases of the hand, face, and body despite recommendations. Additional procedure-specific randomized controlled trials are necessary to provide evidence-based recommendations for antibiotic prophylaxis in plastic surgery.
Level of Evidence: Level IV, risk / prognostic study
KeywordsAntibiotic prophylaxis Antibiotic guidelines Antibiotics plastic surgery
Compliance with ethical standards
Conflict of interest
Shana S. Kalaria, Thanapoom Boonipat, J. Michael Smith, and Eric L. Cole declare that they have no conflict of interest.
For this type of study formal consent is not required.
This work received neither financial support nor funding.
- 1.No authors listed (2012) Antimicrobial prophylaxis for surgery. Treat Guidel Med Lett 10:73–78 quiz 79–80Google Scholar
- 2.Gravante G, Caruso R, Araco A, Cervelli V (2008) Infections after plastic procedures: incidences, etiologies, risk factors, and antibiotic prophylaxis. Aesthetic Plast Surg 32:243–251Google Scholar
- 4.Bratzler DW, Dellinger EP, Olsen KM, Perl TM, Auwaerter PG, Bolon MK, Fish DN, Napolitano LM, Sawyer RG, Slain D, Steinberg JP, Weinstein RA, American Society of Health-System P, Infectious Diseases Society of A, Surgical Infection S, Society for Healthcare Epidemiology of A (2013) Clinical practice guidelines for antimicrobial prophylaxis in surgery. Surg Infect 14:73–156CrossRefGoogle Scholar
- 12.Simmons BP (1982) Guideline for prevention of surgical wound infections. Infect Control 3:185–196Google Scholar
- 17.Hidron AI, Edwards JR, Patel J, Horan TC, Sievert DM, Pollock DA, Fridkin SK, National Healthcare Safety Network T, Participating National Healthcare Safety Network F (2008) NHSN annual update: antimicrobial-resistant pathogens associated with healthcare-associated infections: annual summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006-2007. Infect Control Hosp Epidemiol 29:996–1011CrossRefGoogle Scholar
- 20.Ariyan S, Martin J, Lal A, Cheng D, Borah GL, Chung KC, Conly J, Havlik R, Lee WP, McGrath MH, Pribaz J, Young VL (2015) Antibiotic prophylaxis for preventing surgical-site infection in plastic surgery: an evidence-based consensus conference statement from the American Association of Plastic Surgeons. Plast Reconstr Surg 135:1723–1739CrossRefGoogle Scholar
- 24.Khan UD (2010) Breast augmentation, antibiotic prophylaxis, and infection: comparative analysis of 1,628 primary augmentation mammoplasties assessing the role and efficacy of antibiotics prophylaxis duration. Aesthetic Plast Surg 34:42–47Google Scholar