Is Antibiotic Prophylaxis Necessary in Mastectomy with Antimicrobial Sutures? A Comparative Analysis

Abstract

<p>Background/Objectives: Surgical site infection (SSI) rates following breast surgical procedures range from 0.8% to 26%. Both prophylactic antibiotics and antimicrobial-coated sutures have been shown to play an important role in reducing these complications. This study aimed to evaluate the impact of antibiotic prophylaxis in mastectomy procedures using triclosan-coated sutures. <br></p><p>Methods: This study included 300 consecutive patients who underwent mastectomy for breast cancer over a two-year period, during which triclosan-coated Vicryl Plus sutures were used. Patients were divided into two groups based on the use of antibiotic prophylaxis. The prophylaxis group received 1.5 g cefuroxime intravenously at anesthesia induction (600 mg clindamycin in case of allergy), while the control group received no antibiotics. Endpoints of interest included differences in SSI and specific wound-healing complications at follow-up. <br></p><p>Results: There was no significant difference in the overall SSI rates between the two groups: 23.2% in the prophylaxis group vs. 18.8% in the control group [odds ratio (OR): 0.88; 95% confidence interval (CI): 0.69–1.13; vs. OR: 1.16; 95% CI 0.85–1.58; p = 0.343]. No adverse drug reactions were observed. Staphylococcus aureus was the most isolated microorganism in both groups. Multivariate analysis identified prolonged operative time and hematoma formation as significant predictors of postoperative infection. <br></p><p>Conclusions: Antibiotic prophylaxis did not reduce the rate of SSI following mastectomy for breast cancer when triclosan-coated sutures were used. Further high-quality, independent studies are warranted, particularly in breast surgery context.<br></p>