Local antibiotic prophylaxis in breast reconstruction with breast implants
Authors:
J. Drozd 1; M. Patzelt 2; B. Vyhnánková 1; Z. Šubrt 1
Authors‘ workplace:
Chirurgická klinika 3. LF UK a FN Královské Vinohrady, Praha
1; Klinika plastické chirurgie 3. LF a FN Královské Vinohrady, Praha
2
Published in:
Rozhl. Chir., 2025, roč. 104, č. 11, s. 487-491.
Category:
Review
doi:
https://doi.org/10.48095/ccrvch2025487
Overview
Introduction: Local antibiotic prophylaxis in breast reconstruction with implants is a widely used method aimed at reducing postoperative infections, biofilm formation, and the incidence of capsular contracture, which can ultimately lead to implant loss, breast implant illness, or breast implant-associated anaplastic large cell lymphoma. Currently, there is no convincing guideline or protocol for irrigation, nor a specific antibiotic or combination of antibiotics set. The objective of this systematic review is to summarize the existing knowledge on this topic based on available research.
Methods: A literature review was conducted using the PubMed, Medline, and Google Scholar databases / search engines, focusing on local antibiotic prophylaxis in breast implant reconstruction.
Results: A total of seven studies meeting the inclusion criteria were selected from 79 articles. Across all studies, seven different antibiotic irrigation solutions were compared, involving a total of 2,637 patients.
Conclusion: The study findings suggest that local antibiotic prophylaxis is effective in preventing early surgical site infections and capsular contracture. However, the methodology and study design raise concerns about potential bias and the overall reliability of the results. We believe that this issue remains insufficiently explored and that further high-quality evidence is necessary to establish its efficacy. A clearly defined protocol should be developed and incorporated into official guidelines.
Keywords:
Antibiotic prophylaxis – breast reconstruction – surgical wound infection – postoper¬ative complications – implant capsular contracture
Sources
1. Haynes DF. A Clinical comparison of Irrisept®, triple antibiotic, and combination breast oocket irrigation. In: Pearls of Wisdom. West Palm Beach, Florida 2018 : 69.
2. Merceron TK, Betarbet U, Hart A et al. Comparison of complications following implant-based breast reconstruction using triple antibiotic solution versus low concentration chlorhexidine gluconate solution. Mod Plast Surg 2019; 09(04): 74–85. doi: 10.4236/mps.2019.94010.
3. Adams WP, Rios JL, Smith SJ. Enhancing patient outcomes in aesthetic and reconstructive breast surgery using triple antibiotic breast irrigation: six--year prospective clinical study. Plast Reconstr Surg 2006; 117(1): 30–36. doi: 10.1097/01.prs.0000185671.51993.7e.
4. Giordano S, Peltoniemi H, Lilius P et al. Povidone-iodine combined with antibiotic topical irrigation to reduce capsular contracture in cosmetic breast augmentation: a comparative study. Aesthet Surg J 2013; 33(5): 675–680. doi: 10.1177/1090820X13491490.
5. Pfeiffer P, Jørgensen S, Kristiansen TB et al. Protective effect of topical antibiotics in breast augmentation. Plast Reconstr Surg 2009; 124(2): 629–634. doi: 10.1097/PRS.0b013e3181addc68.
6. Hunsicker LM, Chavez-Abraham V, Berry C et al. Efficacy of vancomycin-based continuous triple antibiotic irrigation in immediate, implant-based breast reconstruction. Plast Reconstr Surg Glob Open 2017; 5(12): e1624. doi: 10.1097/GOX.0000000000001624.
7. Hemmingsen MN, Bennedsen AK, Kullab RB et al. Pharmacokinetics of locally applied antibiotic prophylaxis for implant-based breast reconstruction. JAMA Netw Open 2023; 6(12): e2348414. doi: 10.1001/jamanetworkopen.2023.48414.
8. Jin L, Ba T. Effect of prolonged antibiotic prophylaxis on the occurrence of surgical site wound infection after instant breast reconstruction: a meta-analysis. Int Wound J 2024; 21(4): e14631. doi: 10.1111/iwj.14631.
9. Zhadan O, Becker H. Surgical site irrigation in plastic surgery. Aesthet Surg J 2018; 38(3): 265–273. doi: 10.1093/asj/sjx171.
10. Epps MT, Langsdon S, Pels TK et al. Pocket irrigation and technique during reconstructive surgery: an American Society of Plastic Surgery Survey of current practice. Ann Plast Surg 2019; 82(6S Suppl 5): S427–S432. doi: 10.1097/SAP.0000000000001790.
11. Lin WL, Wu LM, Nguyen TH et al. Topical antibiotic prophylaxis for preventing surgical site infections of clean wounds: a systematic review and meta-analysis. Surg Infect (Larchmt) 2024; 25(1): 32–38. doi: 10.1089/sur.2023.182.
12. Bontekoning N, Huizing NJ, Timmer AS et al. Topical antimicrobial treatment of mesh for the reduction of surgical site infections after hernia repair: a systematic review and meta-analysis. Hernia 2024; 28(3): 691–700. doi: 10.1007/s10029-024-02987-0.
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Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
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