The Role of Antibiotics in Breast Pocket Irrigation and Implant Immersion: A Systematic Review

BACKGROUND:The usage of antibiotics and antiseptics to washout the breast pocket, or to soak the breast implant during surgery, has come under scrutiny in recent times. Guidelines from the Centers for Disease Control and Prevention give no recommendation for or against the usage of antibiotics in th...

Full description

Saved in:
Bibliographic Details
Published in:Plastic and reconstructive surgery. Global open 2018-09, Vol.6 (9), p.e1868-e1868
Main Authors: Frois, Ashley O., Harbour, Patrick O., Azimi, Farhad, Young, Jane, Chan, Belinda, Mak, Cindy, Warrier, Sanjay
Format: Article
Language:English
Subjects:
Original
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:BACKGROUND:The usage of antibiotics and antiseptics to washout the breast pocket, or to soak the breast implant during surgery, has come under scrutiny in recent times. Guidelines from the Centers for Disease Control and Prevention give no recommendation for or against the usage of antibiotics in this regard. They do however offer a weak recommendation for washing tissues with iodophor. This systematic review aims to investigate the efficacy and impact of such topical antibiotic or antiseptic usage in reducing infection rates. METHODS:A systematic electronic search was performed on the PreMEDLINE, MEDLINE, EMBASE, and CENTRAL (Cochrane) databases from inception to April 2017. Reference search was performed manually through Scopus. Results of the searches were independently screened by 2 reviewers (A.F. and P.H.). Studies involving an implant or tissue expander, with appropriate controls were included. Meta-analyses were performed where possible and data summarized when not. RESULTS:Three retrospective cohort studies were found to fit the review requirements. No randomized control trials were found. These studies covered a period of 1996–2010 for a total of 3,768 women undergoing augmentative surgery. The usage of antibiotics in pocket washout or implant immersion resulted in lower infection rates (RR = 0.52; P = 0.004; 95% CI = 0.34–0.81). CONCLUSIONS:There is a clinical benefit in using antibiotics for breast pocket irrigation and implant immersion. However, the quality of the evidence obtained in this review is low; hence, we recommend a randomized control trial for a higher level of evidence on this important issue.
ISSN:2169-7574
2169-7574
DOI:10.1097/GOX.0000000000001868