title: Controversies in Reduction Mammoplasty: Being A "Clean" Operation, Does It Mandate Antibiotic Prophylaxis?
abstract: 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).
  
  
  CONCLUSIONS
  Infection was significantly more common in the group that did not receive prophylaxis.
authors.affiliation: 1 Department of Plastic Surgery, Hospital Agamenon Magalhães, Recife, Pernambuco, Brazil .
authors.forename: Luiz Felipe Duarte Fernandes
authors.initials: LF
authors.lastname: Vieira
authors.affiliation: 1 Department of Plastic Surgery, Hospital Agamenon Magalhães, Recife, Pernambuco, Brazil .
authors.forename: Alberto Ferraz
authors.initials: AF
authors.lastname: De Melo Neto
authors.affiliation: 1 Department of Plastic Surgery, Hospital Agamenon Magalhães, Recife, Pernambuco, Brazil .
authors.forename: Marina Roggia
authors.initials: MR
authors.lastname: Schio
authors.affiliation: 1 Department of Plastic Surgery, Hospital Agamenon Magalhães, Recife, Pernambuco, Brazil .
authors.forename: Jonathan Augusto Vidal
authors.initials: JA
authors.lastname: De Oliveira
authors.affiliation: 1 Department of Plastic Surgery, Hospital Agamenon Magalhães, Recife, Pernambuco, Brazil .
authors.forename: Carlos Lacerda Andrade
authors.initials: CL
authors.lastname: Almeida
authors.affiliation: 2 Department of Surgery, Hospital das Clinicas-Federal University of Pernambuco, Recife, Pernambuco, Brazil .
authors.forename: Alvaro Antonio Bandeira
authors.initials: AA
authors.lastname: Ferraz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D002437:Cefazolin / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects* / Q000379:methods*; D008875:Middle Aged; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D002437:Cefazolin