Controversies in Reduction Mammoplasty: Being A "Clean" Operation, Does It Mandate Antibiotic Prophylaxis?

BACKGROUND: Considered a clean operation, breast surgery has surgical site infection (SSI) rates ranging from 4% to 18%, higher than the reference value for clean surgery (<3.4%). The aim of this study was to measure the incidence of SSI in patients undergoing reduction mammoplasty with and without antibiotic prophylaxis, comparing the results and defining the value of antibiotic prophylaxis.

METHODS: The study was randomized, double-blinded, and interventional. Two groups were formed randomly, with 75 patients in each. Group 1 received prophylactic antibiotic (cefazolin 2 g 30 min before surgery with repetition at 1 g every 3 h during surgery), and Group 2 (control) did not have antibiotic prophylaxis. Patients were followed until the 30th post-operative day for identification of SSI.

RESULTS: There were 13 cases of SSI, 3 in Group 1 (4.1%) and 10 in Group 2 (13.9%) (p = 0.039). Their secretion cultures were positive for Staphylococcus aureus. There were more cases of SSI in patients having greater resections (n = 9), but the difference was not significant (p = 0.051).

CONCLUSION: Infection was significantly more common in the group that did not receive prophylaxis.