Skip to main content

Advertisement

SpringerLink
Log in

National Practice Patterns in Preoperative and Postoperative Antibiotic Prophylaxis in Breast Procedures Requiring Drains: Survey of the American Society of Breast Surgeons

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

To assess national practice patterns regarding use of perioperative antibiotics by surgeons performing breast operations requiring drainage tubes.

Methods

The members of the American Society of Breast Surgeons (ASBrS) were surveyed regarding use of perioperative antibiotics for breast operations requiring drains, with or without immediate tissue expander or implant reconstruction.

Results

Of 2,857 ASBrS members contacted, 917 (32 %) responded; all self-identified as surgeons. Of 905 evaluable respondents, most described themselves as general surgeons (46 %) or breast surgeons (46 %). For cases in which drains are anticipated, most respondents (86 %) reported routine use of preoperative prophylactic antibiotics, with 99 % selecting cephalosporins. Use of antibiotic >24 h postoperatively varied by whether or not reconstruction was performed. In nonreconstruction cases, the majority (76 %) reported “never/almost never” prescribing antibiotics beyond the 24-h postoperative period, but 16 % reported “always/almost always.” In reconstruction cases, the majority (58 %) reported routine antibiotic use beyond 24 h, and the primary driver of the decision to use antibiotics was reported to be the plastic surgeon (83 %). Among those reporting use at >24 h, the duration recommended for nonreconstruction cases was “up to 1 week” in 38 % and “until drains removed” in 39 %; this was similar for reconstruction cases.

Conclusions

Cephalosporins are utilized uniformly as preoperative antibiotic prophylaxis in breast operations requiring drains. However, use of postoperative antibiotic prophylaxis is strongly dependent on the presence of immediate breast reconstruction. Consensus is lacking on the role of postoperative antibiotic prophylaxis in breast operations utilizing drains.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Vilar-Compte D, Jacquemin B, Robles-Vidal C, Volkow P. Surgical site infections in breast surgery: case-control study. World J Surg. 2004;28:242–6.

    Article  PubMed  Google Scholar 

  2. Ruvalcaba-Limon E, Robles-Vidal C, Poitevin-Chacon A, Chavez-Macgregor M, Gamboa-Vignolle C, Vilar-Compte D. Complications after breast cancer surgery in patients treated with concomitant preoperative chemoradiation: a case-control analysis. Breast Cancer Res Treat. 2006;95:147–52.

    Article  PubMed  Google Scholar 

  3. Prospero E, Cavicchi A, Bacelli S, Barbadoro P, Tantucci L, D’Errico MM. Surveillance for surgical site infection after hospital discharge: a surgical procedure–specific perspective. Infect Control Epidemiol. 2006;27:1313–7.

    Article  CAS  Google Scholar 

  4. Neumayer L, Schifftner TL, Henderson WG, Khuri SF, El-Tamer M. Breast cancer surgery in Veterans Affairs and selected university medical centers: results of the patient safety in surgery study. J Am Coll Surg. 2007;204:1235–41.

    Article  PubMed  Google Scholar 

  5. Nahabedian MY, Tsangaris T, Momen B, Manson PN. Infectious complications following breast reconstruction with expanders and implants. Plastic Reconstr Surg. 2003;112:467–76.

    Article  Google Scholar 

  6. Edwards JR, Peterson KD, Mu Y, et al. National Healthcare Safety Network (NHSN) report: data summary for 2006 through 2008, issued December 2009. Am J Infect Control. 2009;37:783–805.

    Article  PubMed  Google Scholar 

  7. Alderman AK, Wilkins EG, Kim HM, Lowery JC. Complications in postmastectomy breast reconstruction: two-year results of the Michigan Breast Reconstruction Outcome Study. Plastic Reconstr Surg. 2002;109:2265–74.

    Article  Google Scholar 

  8. de Blacam C, Ogunleye AA, Momoh AO, et al. High body mass index and smoking predict morbidity in breast cancer surgery: a multivariate analysis of 26,988 patients from the national surgical quality improvement program database. Ann Surg. 2012;255:551–5.

    Article  PubMed  Google Scholar 

  9. Olsen MA, Lefta M, Dietz JR, et al. Risk factors for surgical site infection after major breast operation. J Am Coll Surg. 2008;207:326–35.

    Article  PubMed  Google Scholar 

  10. Felippe WA, Werneck GL, Santoro-Lopes G. Surgical site infection among women discharged with a drain in situ after breast cancer surgery. World J Surg. 2007;31:2293–9.

    Article  PubMed  Google Scholar 

  11. Lanier ST, Wang ED, Phillips BT, Khan SU, Dagum AB, Bui DT. The association between closed suction drainage duration and complication rates in tissue expander/implant breast reconstruction with antibiotic prophylaxis. Plastic Reconstr Surg. 2010;125(6S):67.

    Article  Google Scholar 

  12. American Society of Health-System Pharmacists. ASHP therapeutic guidelines on antimicrobial prophylaxis in surgery. Am J Health Syst Pharm. 1999;56:1839–88.

    Google Scholar 

  13. Rosenberger LH, Politano AD, Sawyer RG. The surgical care improvement project and prevention of post-operative infection, including surgical site infection. Surg Infect (Larchmt). 2011;12:163–8.

    Article  Google Scholar 

  14. Throckmorton AD, Baddour LM, Hoskin TL, Boughey JC, Degnim AC. Microbiology of surgical site infections complicating breast surgery. Surg Infect (Larchmt). 2010;11:355–9.

    Article  Google Scholar 

  15. Throckmorton AD, Boughey JC, Boostrom SY, et al. Postoperative prophylactic antibiotics and surgical site infection rates in breast surgery patients. Ann Surg Oncol. 2009;16:2464–9.

    Article  PubMed  Google Scholar 

  16. Phillips BT, Wang ED, Mirrer J, et al. Current practice among plastic surgeons of antibiotic prophylaxis and closed-suction drains in breast reconstruction: experience, evidence, and implications for postoperative care. Ann Plast Surg. 2011;66:460–5.

    Article  PubMed  CAS  Google Scholar 

  17. Scow JS, Hoskin TL, Boughey JC, et al. Randomized controlled trial to reduce bacterial colonization of surgical drains after breast and axillary operations. Ann Surg Oncol. 2011;18:S180–S.

    Google Scholar 

Download references

Acknowledgment

Supported in part by intramural funds. Amy C. Degnim is supported by the CA90628-08 Paul Calabresi Award for Clinical-Translational Research (K12) via the Mayo Clinic Cancer Center. R.B. is supported by the Mayo Clinic Clinical Investigator Program. This project was also supported by NIH/NCRR CTSA grant UL1 RR024150. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. Sincere appreciation to Marilyn Churchward for assistance with preparation of the article.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Surgery, Mayo Clinic, Rochester, MN, USA

    Rushin D. Brahmbhatt MD, Jeffrey S. Scow MD, Judy C. Boughey MD, James W. Jakub MD, Tina J. Hieken MD & Amy C. Degnim MD

  2. Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA

    Marianne Huebner PhD & W. Scott Harmsen MS

  3. Survey Research Center, Mayo Clinic, Rochester, MN, USA

    Ann M. Harris BA & Donna Goede AA

Authors
  1. Rushin D. Brahmbhatt MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marianne Huebner PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jeffrey S. Scow MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. W. Scott Harmsen MS
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Judy C. Boughey MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ann M. Harris BA
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Donna Goede AA
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. James W. Jakub MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Tina J. Hieken MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Amy C. Degnim MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Amy C. Degnim MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Brahmbhatt, R.D., Huebner, M., Scow, J.S. et al. National Practice Patterns in Preoperative and Postoperative Antibiotic Prophylaxis in Breast Procedures Requiring Drains: Survey of the American Society of Breast Surgeons. Ann Surg Oncol 19, 3205–3211 (2012). https://doi.org/10.1245/s10434-012-2477-1

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-012-2477-1

Keywords

Search

Navigation