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. 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. 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 aureuswas the most isolated microorganism in both groups. Multivariate analysis identified prolonged operative time and hematoma formation as significant predictors of postoperative infection. 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.
背景/目的：乳腺外科手术后手术部位感染（SSI）的发生率在0.8%至26%之间。预防性抗生素和抗菌涂层缝线均被证实对降低此类并发症具有重要作用。本研究旨在评估在使用三氯生涂层缝线的乳房切除术中，抗生素预防措施的影响。方法：本研究纳入了两年期间连续300例因乳腺癌接受乳房切除术的患者，所有患者均使用了三氯生涂层的Vicryl Plus缝线。根据是否使用抗生素预防，将患者分为两组。预防组在麻醉诱导时静脉注射1.5 g头孢呋辛（过敏者使用600 mg克林霉素），而对照组未使用任何抗生素。关注的终点包括随访时SSI及特定伤口愈合并发症的差异。结果：两组间的总体SSI发生率无显著差异：预防组为23.2%，对照组为18.8%[比值比（OR）：0.88；95%置信区间（CI）：0.69–1.13；对比OR：1.16；95% CI：0.85–1.58；p=0.343]。未观察到药物不良反应。金黄色葡萄球菌是两组中最常分离出的微生物。多变量分析确定手术时间延长和血肿形成是术后感染的显著预测因素。结论：在使用三氯生涂层缝线的情况下，抗生素预防并未降低乳腺癌乳房切除术后的SSI发生率。有必要开展进一步高质量、独立的研究，尤其是在乳腺外科领域。
Is Antibiotic Prophylaxis Necessary in Mastectomy with Antimicrobial Sutures? A Comparative Analysis
肿瘤(癌症)患者之家