title: Postoperative antibiotic prophylaxis for implant-based breast reconstruction with acellular dermal matrix.
abstract: BACKGROUND
  The use of acellular dermal matrix in implant-based breast reconstruction has been described for improving inferolateral prosthesis coverage and support and inframammary fold reconstruction. Recommended guidelines for infection prophylaxis are the same as for any clean procedure-antibiotic administration only before surgery. Previous studies have demonstrated increased postoperative rates of infection and seroma associated with the use of acellular dermal matrix. The authors evaluated the impact of postoperative antibiotic prophylaxis on infection rates in postmastectomy expander-based breast reconstruction with acellular dermal matrix.
  
  
  METHODS
  : A retrospective study reviewed data of 96 patients who underwent either immediate or delayed expander-based breast reconstruction using AlloDerm allogenic acellular dermal matrix. Infection rates were analyzed after patients received postoperative antibiotic prophylaxis for at least 48 hours compared with those who received only perioperative antibiotics.
  
  
  RESULTS
  Infection rates for breast reconstructions with a postoperative antibiotic course were 7.9 and 3.2 percent. Patients with only perioperative antibiotics had an infection rate of 31.6 percent. Infections were defined by the endpoint of implant removal. Patient demographics, comorbidities, and intraoperative variables were recorded. Uncontrolled variables were time course between mastectomy and reconstruction, nodal dissection, operative history, and whether reconstruction was unilateral or bilateral.
  
  
  CONCLUSIONS
  This study demonstrates significant differences in the rate of infection between the groups of patients undergoing the first stage of two-stage implant-based breast reconstruction who received postoperative antibiotic prophylaxis and the group that received only perioperative antibiotics. This study suggests that the optimal duration of postoperative antibiotic prophylaxis is at least 48 hours.
authors: Miami, Fla.; and Baltimore, Md. From the University of Miami Miller School of Medicine; the Department of Plastic and Reconstructive Surgery, The Johns Hopkins University; and the DeWitt Daughtry Family Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Miami Miller School of Medicine.
authors: Yash J
authors: YJ
authors: Avashia
authors: Raja
authors: R
authors: Mohan
authors: ChiChi
authors: C
authors: Berhane
authors: John C
authors: JC
authors: Oeltjen
mesh_terms: D062088:Acellular Dermis; D019072:Antibiotic Prophylaxis; D018427:Breast Implants; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D011182:Postoperative Care; D016459:Prosthesis-Related Infections / Q000517:prevention & control*; D012189:Retrospective Studies