Stephan Ariyan1, Janet Martin, Avtar Lal, Davy Cheng, Gregory L Borah, Kevin C Chung, John Conly, Robert Havlik, W P Andrew Lee, Mary H McGrath, Julian Pribaz, V Leroy Young. 1. New Haven, Conn.; New Brunswick, N.J.; Ann Arbor, Mich.; Milwaukee, Wis.; Baltimore, Md.; San Francisco, Calif.; Boston, Mass.; Washington, Mo.; and London, Ontario, and Calgary, Alberta, Canada From the Department of Surgery (Plastic Surgery), Yale University; the Department of Surgery, University of Medicine and Dentistry of New Jersey; the Department of Surgery, University of Michigan; the Department of Plastic Surgery, Medical College of Wisconsin; the Department of Surgery, Johns Hopkins University; the Department of Surgery, University of California, San Francisco; the Department of Surgery, Harvard University; Mercy Health Research; the Department of Anesthesia and Perioperative Medicine, Western University; and the Department of Medicine, Microbiology, Immunology and Infectious Diseases, and Snyder Institute for Chronic Diseases, University of Calgary.
Abstract
BACKGROUND: There is a growing concern for microbial resistance as a result of overuse of antibiotics. Although guidelines have focused on the use of antibiotics for surgery in general, few have addressed plastic surgery specifically. The objective of this expert consensus conference was to evaluate the evidence for efficacy and safety of antibiotic prophylaxis in plastic surgical procedures. METHODS: THE AUTHORS: searched for existing high-quality systematic reviews for antibiotic prophylaxis in the literature from the MEDLINE, Cochrane Library, and Embase databases. All synonyms for antibiotics were combined with terms for relevant plastic surgery procedures. The searches were not limited by language, and included all study designs. In addition, supplemental hand searches were performed of bibliographies of relevant articles, and extensive "related articles." Meta-analyses were performed and reviewed by experts selected by the American Association of Plastic Surgeons to reach consensus recommendations. RESULTS: Database searches identified 4300 articles, from which 2042 full-text articles were identified for eligibility. De novo meta-analyses were performed for each plastic surgical category. In total, 67 studies met the inclusion criteria, including nine for breast surgery, 17 for head and neck surgery, 10 for orthognathic surgery, seven for rhinoplasty/septoplasty, 19 for hand surgery, five for skin surgery, and two for abdominoplasty. CONCLUSIONS: Systemic antibiotic prophylaxis is recommended for clean breast surgery and for contaminated surgery of the hand or the head and neck. It is not recommended to reduce infection in clean surgical cases of the hand, skin, head and neck, or abdominoplasty.
BACKGROUND: There is a growing concern for microbial resistance as a result of overuse of antibiotics. Although guidelines have focused on the use of antibiotics for surgery in general, few have addressed plastic surgery specifically. The objective of this expert consensus conference was to evaluate the evidence for efficacy and safety of antibiotic prophylaxis in plastic surgical procedures. METHODS: THE AUTHORS: searched for existing high-quality systematic reviews for antibiotic prophylaxis in the literature from the MEDLINE, Cochrane Library, and Embase databases. All synonyms for antibiotics were combined with terms for relevant plastic surgery procedures. The searches were not limited by language, and included all study designs. In addition, supplemental hand searches were performed of bibliographies of relevant articles, and extensive "related articles." Meta-analyses were performed and reviewed by experts selected by the American Association of Plastic Surgeons to reach consensus recommendations. RESULTS: Database searches identified 4300 articles, from which 2042 full-text articles were identified for eligibility. De novo meta-analyses were performed for each plastic surgical category. In total, 67 studies met the inclusion criteria, including nine for breast surgery, 17 for head and neck surgery, 10 for orthognathic surgery, seven for rhinoplasty/septoplasty, 19 for hand surgery, five for skin surgery, and two for abdominoplasty. CONCLUSIONS: Systemic antibiotic prophylaxis is recommended for clean breast surgery and for contaminated surgery of the hand or the head and neck. It is not recommended to reduce infection in clean surgical cases of the hand, skin, head and neck, or abdominoplasty.
Authors: Brian M Lin; Michelle White; Ana Glover; Greta Peterson Wamah; Davi L Trotti; Kirstie Randall; Blake C Alkire; Mack L Cheney; Gary Parker; Mark G Shrime Journal: World J Surg Date: 2017-01 Impact factor: 3.352
Authors: Alexander K Bartella; Sebastian Lemmen; Aida Burnic; Anita Kloss-Brandstätter; Mohammad Kamal; Thomas Breisach; Frank Hölzle; Bernd Lethaus Journal: Infection Date: 2017-12-18 Impact factor: 3.553