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Evaluation of Current Perioperative Antimicrobial Regimens for the Prevention of Surgical Site Infections in Breast Implant-based Reconstructive Surgeries
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| Zeitschriftentitel: | Plastic and Reconstructive Surgery - Global Open |
|---|---|
| Personen und Körperschaften: | , , , , , , , , |
| In: | Plastic and Reconstructive Surgery - Global Open, 7, 2019, 7, S. e2342 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
Ovid Technologies (Wolters Kluwer Health)
|
| Schlagwörter: |
| author_facet |
Viola, George M. Rolston, Kenneth V. Butler, Charles Selber, Jesse Reece, Gregory Clemens, Mark Villa, Mark Raad, Issam I. Baumann, Donald Viola, George M. Rolston, Kenneth V. Butler, Charles Selber, Jesse Reece, Gregory Clemens, Mark Villa, Mark Raad, Issam I. Baumann, Donald |
|---|---|
| author |
Viola, George M. Rolston, Kenneth V. Butler, Charles Selber, Jesse Reece, Gregory Clemens, Mark Villa, Mark Raad, Issam I. Baumann, Donald |
| spellingShingle |
Viola, George M. Rolston, Kenneth V. Butler, Charles Selber, Jesse Reece, Gregory Clemens, Mark Villa, Mark Raad, Issam I. Baumann, Donald Plastic and Reconstructive Surgery - Global Open Evaluation of Current Perioperative Antimicrobial Regimens for the Prevention of Surgical Site Infections in Breast Implant-based Reconstructive Surgeries Surgery General Medicine |
| author_sort |
viola, george m. |
| spelling |
Viola, George M. Rolston, Kenneth V. Butler, Charles Selber, Jesse Reece, Gregory Clemens, Mark Villa, Mark Raad, Issam I. Baumann, Donald 2169-7574 Ovid Technologies (Wolters Kluwer Health) Surgery General Medicine http://dx.doi.org/10.1097/gox.0000000000002342 <jats:sec> <jats:title>Background:</jats:title> <jats:p>Several steps to reduce the rate of postoperative surgical site infections (SSIs) have been implemented. The use of prophylactic antimicrobials targeting patient’s microbial flora has been associated with a decrease in postoperative infections. We evaluated the relationship between perioperative antimicrobials, baseline microbial flora, and occurrence of SSIs.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>We prospectively enrolled 241 patients scheduled to receive a postmastectomy implant-based reconstructive procedure between September 2015 and January 2018. Axillary swab cultures were obtained preoperatively, and all recovered bacteria were identified. Surgeons were blinded to these results. The use of prophylactic perioperative antimicrobials was defined as concordant if the baseline axillary flora were susceptible to the given antibiotic and discordant if not. As <jats:italic toggle="yes">Staphylococcus</jats:italic> species are the most common pathogen causative for breast implant-related infections, patients colonized with these organisms were analyzed in detail. All patients were followed up for at least 6 months postoperatively and evaluated for SSIs.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>A total of 238 patients (99%) received both perioperative and postoperative oral antimicrobials. The most common preoperative staphylococci axillary flora recovered were methicillin-sensitive coagulase-negative <jats:italic toggle="yes">Staphylococcus</jats:italic> (67%), methicillin-resistant coagulase-negative <jats:italic toggle="yes">Staphylococcus</jats:italic> (35%), with only 1 case of methicillin-sensitive <jats:italic toggle="yes">Staphylococcus aureus</jats:italic> (0.4%). Thirty-three patients (14%) developed an SSI. Of those with a positive <jats:italic toggle="yes">Staphylococcus</jats:italic> culture, only 54% received a concordant antimicrobial regimen, but this was not associated with an increased risk for infection (<jats:italic toggle="yes">P</jats:italic> > 0.72).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>The use of perioperative antimicrobials whether concordant or discordant with the preoperative axillary microbial flora, specifically <jats:italic toggle="yes">Staphylococci</jats:italic> species, did not provide a significant impact on the risk of SSI.</jats:p> </jats:sec> Evaluation of Current Perioperative Antimicrobial Regimens for the Prevention of Surgical Site Infections in Breast Implant-based Reconstructive Surgeries Plastic and Reconstructive Surgery - Global Open |
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10.1097/gox.0000000000002342 |
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Online Free |
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Ovid Technologies (Wolters Kluwer Health), 2019 |
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Ovid Technologies (Wolters Kluwer Health), 2019 |
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2169-7574 |
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2019 |
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Plastic and Reconstructive Surgery - Global Open |
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| title |
Evaluation of Current Perioperative Antimicrobial Regimens for the Prevention of Surgical Site Infections in Breast Implant-based Reconstructive Surgeries |
| title_unstemmed |
Evaluation of Current Perioperative Antimicrobial Regimens for the Prevention of Surgical Site Infections in Breast Implant-based Reconstructive Surgeries |
| title_full |
Evaluation of Current Perioperative Antimicrobial Regimens for the Prevention of Surgical Site Infections in Breast Implant-based Reconstructive Surgeries |
| title_fullStr |
Evaluation of Current Perioperative Antimicrobial Regimens for the Prevention of Surgical Site Infections in Breast Implant-based Reconstructive Surgeries |
| title_full_unstemmed |
Evaluation of Current Perioperative Antimicrobial Regimens for the Prevention of Surgical Site Infections in Breast Implant-based Reconstructive Surgeries |
| title_short |
Evaluation of Current Perioperative Antimicrobial Regimens for the Prevention of Surgical Site Infections in Breast Implant-based Reconstructive Surgeries |
| title_sort |
evaluation of current perioperative antimicrobial regimens for the prevention of surgical site infections in breast implant-based reconstructive surgeries |
| topic |
Surgery General Medicine |
| url |
http://dx.doi.org/10.1097/gox.0000000000002342 |
| publishDate |
2019 |
| physical |
e2342 |
| description |
<jats:sec>
<jats:title>Background:</jats:title>
<jats:p>Several steps to reduce the rate of postoperative surgical site infections (SSIs) have been implemented. The use of prophylactic antimicrobials targeting patient’s microbial flora has been associated with a decrease in postoperative infections. We evaluated the relationship between perioperative antimicrobials, baseline microbial flora, and occurrence of SSIs.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods:</jats:title>
<jats:p>We prospectively enrolled 241 patients scheduled to receive a postmastectomy implant-based reconstructive procedure between September 2015 and January 2018. Axillary swab cultures were obtained preoperatively, and all recovered bacteria were identified. Surgeons were blinded to these results. The use of prophylactic perioperative antimicrobials was defined as concordant if the baseline axillary flora were susceptible to the given antibiotic and discordant if not. As <jats:italic toggle="yes">Staphylococcus</jats:italic> species are the most common pathogen causative for breast implant-related infections, patients colonized with these organisms were analyzed in detail. All patients were followed up for at least 6 months postoperatively and evaluated for SSIs.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results:</jats:title>
<jats:p>A total of 238 patients (99%) received both perioperative and postoperative oral antimicrobials. The most common preoperative staphylococci axillary flora recovered were methicillin-sensitive coagulase-negative <jats:italic toggle="yes">Staphylococcus</jats:italic> (67%), methicillin-resistant coagulase-negative <jats:italic toggle="yes">Staphylococcus</jats:italic> (35%), with only 1 case of methicillin-sensitive <jats:italic toggle="yes">Staphylococcus aureus</jats:italic> (0.4%). Thirty-three patients (14%) developed an SSI. Of those with a positive <jats:italic toggle="yes">Staphylococcus</jats:italic> culture, only 54% received a concordant antimicrobial regimen, but this was not associated with an increased risk for infection (<jats:italic toggle="yes">P</jats:italic> > 0.72).</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Conclusions:</jats:title>
<jats:p>The use of perioperative antimicrobials whether concordant or discordant with the preoperative axillary microbial flora, specifically <jats:italic toggle="yes">Staphylococci</jats:italic> species, did not provide a significant impact on the risk of SSI.</jats:p>
</jats:sec> |
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| author | Viola, George M., Rolston, Kenneth V., Butler, Charles, Selber, Jesse, Reece, Gregory, Clemens, Mark, Villa, Mark, Raad, Issam I., Baumann, Donald |
| author_facet | Viola, George M., Rolston, Kenneth V., Butler, Charles, Selber, Jesse, Reece, Gregory, Clemens, Mark, Villa, Mark, Raad, Issam I., Baumann, Donald, Viola, George M., Rolston, Kenneth V., Butler, Charles, Selber, Jesse, Reece, Gregory, Clemens, Mark, Villa, Mark, Raad, Issam I., Baumann, Donald |
| author_sort | viola, george m. |
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| description | <jats:sec> <jats:title>Background:</jats:title> <jats:p>Several steps to reduce the rate of postoperative surgical site infections (SSIs) have been implemented. The use of prophylactic antimicrobials targeting patient’s microbial flora has been associated with a decrease in postoperative infections. We evaluated the relationship between perioperative antimicrobials, baseline microbial flora, and occurrence of SSIs.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>We prospectively enrolled 241 patients scheduled to receive a postmastectomy implant-based reconstructive procedure between September 2015 and January 2018. Axillary swab cultures were obtained preoperatively, and all recovered bacteria were identified. Surgeons were blinded to these results. The use of prophylactic perioperative antimicrobials was defined as concordant if the baseline axillary flora were susceptible to the given antibiotic and discordant if not. As <jats:italic toggle="yes">Staphylococcus</jats:italic> species are the most common pathogen causative for breast implant-related infections, patients colonized with these organisms were analyzed in detail. All patients were followed up for at least 6 months postoperatively and evaluated for SSIs.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>A total of 238 patients (99%) received both perioperative and postoperative oral antimicrobials. The most common preoperative staphylococci axillary flora recovered were methicillin-sensitive coagulase-negative <jats:italic toggle="yes">Staphylococcus</jats:italic> (67%), methicillin-resistant coagulase-negative <jats:italic toggle="yes">Staphylococcus</jats:italic> (35%), with only 1 case of methicillin-sensitive <jats:italic toggle="yes">Staphylococcus aureus</jats:italic> (0.4%). Thirty-three patients (14%) developed an SSI. Of those with a positive <jats:italic toggle="yes">Staphylococcus</jats:italic> culture, only 54% received a concordant antimicrobial regimen, but this was not associated with an increased risk for infection (<jats:italic toggle="yes">P</jats:italic> > 0.72).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>The use of perioperative antimicrobials whether concordant or discordant with the preoperative axillary microbial flora, specifically <jats:italic toggle="yes">Staphylococci</jats:italic> species, did not provide a significant impact on the risk of SSI.</jats:p> </jats:sec> |
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| spelling | Viola, George M. Rolston, Kenneth V. Butler, Charles Selber, Jesse Reece, Gregory Clemens, Mark Villa, Mark Raad, Issam I. Baumann, Donald 2169-7574 Ovid Technologies (Wolters Kluwer Health) Surgery General Medicine http://dx.doi.org/10.1097/gox.0000000000002342 <jats:sec> <jats:title>Background:</jats:title> <jats:p>Several steps to reduce the rate of postoperative surgical site infections (SSIs) have been implemented. The use of prophylactic antimicrobials targeting patient’s microbial flora has been associated with a decrease in postoperative infections. We evaluated the relationship between perioperative antimicrobials, baseline microbial flora, and occurrence of SSIs.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>We prospectively enrolled 241 patients scheduled to receive a postmastectomy implant-based reconstructive procedure between September 2015 and January 2018. Axillary swab cultures were obtained preoperatively, and all recovered bacteria were identified. Surgeons were blinded to these results. The use of prophylactic perioperative antimicrobials was defined as concordant if the baseline axillary flora were susceptible to the given antibiotic and discordant if not. As <jats:italic toggle="yes">Staphylococcus</jats:italic> species are the most common pathogen causative for breast implant-related infections, patients colonized with these organisms were analyzed in detail. All patients were followed up for at least 6 months postoperatively and evaluated for SSIs.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>A total of 238 patients (99%) received both perioperative and postoperative oral antimicrobials. The most common preoperative staphylococci axillary flora recovered were methicillin-sensitive coagulase-negative <jats:italic toggle="yes">Staphylococcus</jats:italic> (67%), methicillin-resistant coagulase-negative <jats:italic toggle="yes">Staphylococcus</jats:italic> (35%), with only 1 case of methicillin-sensitive <jats:italic toggle="yes">Staphylococcus aureus</jats:italic> (0.4%). Thirty-three patients (14%) developed an SSI. Of those with a positive <jats:italic toggle="yes">Staphylococcus</jats:italic> culture, only 54% received a concordant antimicrobial regimen, but this was not associated with an increased risk for infection (<jats:italic toggle="yes">P</jats:italic> > 0.72).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>The use of perioperative antimicrobials whether concordant or discordant with the preoperative axillary microbial flora, specifically <jats:italic toggle="yes">Staphylococci</jats:italic> species, did not provide a significant impact on the risk of SSI.</jats:p> </jats:sec> Evaluation of Current Perioperative Antimicrobial Regimens for the Prevention of Surgical Site Infections in Breast Implant-based Reconstructive Surgeries Plastic and Reconstructive Surgery - Global Open |
| spellingShingle | Viola, George M., Rolston, Kenneth V., Butler, Charles, Selber, Jesse, Reece, Gregory, Clemens, Mark, Villa, Mark, Raad, Issam I., Baumann, Donald, Plastic and Reconstructive Surgery - Global Open, Evaluation of Current Perioperative Antimicrobial Regimens for the Prevention of Surgical Site Infections in Breast Implant-based Reconstructive Surgeries, Surgery, General Medicine |
| title | Evaluation of Current Perioperative Antimicrobial Regimens for the Prevention of Surgical Site Infections in Breast Implant-based Reconstructive Surgeries |
| title_full | Evaluation of Current Perioperative Antimicrobial Regimens for the Prevention of Surgical Site Infections in Breast Implant-based Reconstructive Surgeries |
| title_fullStr | Evaluation of Current Perioperative Antimicrobial Regimens for the Prevention of Surgical Site Infections in Breast Implant-based Reconstructive Surgeries |
| title_full_unstemmed | Evaluation of Current Perioperative Antimicrobial Regimens for the Prevention of Surgical Site Infections in Breast Implant-based Reconstructive Surgeries |
| title_short | Evaluation of Current Perioperative Antimicrobial Regimens for the Prevention of Surgical Site Infections in Breast Implant-based Reconstructive Surgeries |
| title_sort | evaluation of current perioperative antimicrobial regimens for the prevention of surgical site infections in breast implant-based reconstructive surgeries |
| title_unstemmed | Evaluation of Current Perioperative Antimicrobial Regimens for the Prevention of Surgical Site Infections in Breast Implant-based Reconstructive Surgeries |
| topic | Surgery, General Medicine |
| url | http://dx.doi.org/10.1097/gox.0000000000002342 |