Perioperative Antibiotic Prophylaxis And Surgical Site Infections In Implant-based Breast Reconstruction
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2026
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| author | Aryan Gupta Natalia Mejia Alexander Chang Adam Walchak Sameer Patel LKSOM Temple University Hospital / Fox Chase Cancer Center Philadelphia |
| author_facet | Aryan Gupta Natalia Mejia Alexander Chang Adam Walchak Sameer Patel LKSOM Temple University Hospital / Fox Chase Cancer Center Philadelphia |
| contents | PURPOSE: Surgical site infections (SSIs) significantly impact morbidity and reconstructive outcomes following implant-based breast reconstruction after mastectomy. Perioperative antibiotic prophylaxis is central to infection prevention, with cefazolin commonly used as the first-line agent. Although true β-lactam allergy is uncommon and cross-reactivity with cefazolin is rare, penicillin allergy labels frequently lead to the use of second or third-line antibiotics. We evaluated perioperative antibiotic prophylaxis patterns and SSI rates among patients with reported penicillin allergies undergoing implant-based breast reconstruction. METHODS: A single-center retrospective chart review was conducted of adult patients who underwent implant-based breast reconstruction between July 2016 and December 2025. Data regarding reported penicillin allergy status and perioperative antibiotic prophylaxis were collected. Primary outcomes included SSI rates among penicillin-allergic and non-penicillin-allergic patients, as well as the incidence of anaphylactic reactions. RESULTS: The study included 614 patients who underwent a total of 923 implant-based reconstruction procedures. All patients were women, with a mean age of 58.1 years and a mean body mass index of 28.2. A total of 94 patients (15.3%) carried a documented penicillin allergy label. Among these, 6 patients (1.0%) reported a history of anaphylaxis, 3 patients (0.5%) had a documented drug-induced hepatotoxicity reaction, and 85 patients (13.8%) reported a nonanaphylactic reaction or had no documented reaction type. SSI rates were significantly higher among patients who received alternative prophylactic antibiotics compared with those who received standard cefazolin prophylaxis (8.8% vs 3.8%, P = 0.023). No anaphylactic reactions to perioperative antibiotic prophylaxis were observed in either group. CONCLUSION: Use of alternative perioperative antibiotic prophylaxis was associated with increased SSI rates. First-generation cephalosporins remain appropriate first-line agents for implant-based breast reconstruction, while alternative antibiotics may be best reserved for patients with clearly documented severe hypersensitivity reactions. *Source: https://ps-rc.org/meeting/Program/2026/EP127.cgi* |
| format | Recurso digital |
| id | zenodo_https___doi_org_10_5281_zenodo_20064719 |
| institution | Zenodo |
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| publishDate | 2026 |
| publisher | Zenodo |
| record_format | zenodo |
| spellingShingle | Perioperative Antibiotic Prophylaxis And Surgical Site Infections In Implant-based Breast Reconstruction Aryan Gupta Natalia Mejia Alexander Chang Adam Walchak Sameer Patel LKSOM Temple University Hospital / Fox Chase Cancer Center Philadelphia plastic surgery reconstructive surgery conference abstract PSRC 2026 PURPOSE: Surgical site infections (SSIs) significantly impact morbidity and reconstructive outcomes following implant-based breast reconstruction after mastectomy. Perioperative antibiotic prophylaxis is central to infection prevention, with cefazolin commonly used as the first-line agent. Although true β-lactam allergy is uncommon and cross-reactivity with cefazolin is rare, penicillin allergy labels frequently lead to the use of second or third-line antibiotics. We evaluated perioperative antibiotic prophylaxis patterns and SSI rates among patients with reported penicillin allergies undergoing implant-based breast reconstruction. METHODS: A single-center retrospective chart review was conducted of adult patients who underwent implant-based breast reconstruction between July 2016 and December 2025. Data regarding reported penicillin allergy status and perioperative antibiotic prophylaxis were collected. Primary outcomes included SSI rates among penicillin-allergic and non-penicillin-allergic patients, as well as the incidence of anaphylactic reactions. RESULTS: The study included 614 patients who underwent a total of 923 implant-based reconstruction procedures. All patients were women, with a mean age of 58.1 years and a mean body mass index of 28.2. A total of 94 patients (15.3%) carried a documented penicillin allergy label. Among these, 6 patients (1.0%) reported a history of anaphylaxis, 3 patients (0.5%) had a documented drug-induced hepatotoxicity reaction, and 85 patients (13.8%) reported a nonanaphylactic reaction or had no documented reaction type. SSI rates were significantly higher among patients who received alternative prophylactic antibiotics compared with those who received standard cefazolin prophylaxis (8.8% vs 3.8%, P = 0.023). No anaphylactic reactions to perioperative antibiotic prophylaxis were observed in either group. CONCLUSION: Use of alternative perioperative antibiotic prophylaxis was associated with increased SSI rates. First-generation cephalosporins remain appropriate first-line agents for implant-based breast reconstruction, while alternative antibiotics may be best reserved for patients with clearly documented severe hypersensitivity reactions. *Source: https://ps-rc.org/meeting/Program/2026/EP127.cgi* |
| title | Perioperative Antibiotic Prophylaxis And Surgical Site Infections In Implant-based Breast Reconstruction |
| topic | plastic surgery reconstructive surgery conference abstract PSRC 2026 |
| url | https://doi.org/10.5281/zenodo.20064719 |