{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T11:58:22Z","timestamp":1785239902970,"version":"3.55.0"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2016,6,1]],"date-time":"2016-06-01T00:00:00Z","timestamp":1464739200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Closed-suction drains, implants, and acellular dermal matrix (ADM) are routinely used in tissue expander-based immediate breast reconstruction (TE-IBR). Each of these factors is thought to increase the potential for surgical site infection (SSI). Although CDC guidelines recommend only 24 hours of antibiotic prophylaxis after TE-IBR, current clinical practices vary significantly. This study evaluated the difference in SSI between 2 different prophylactic antibiotic durations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>STUDY DESIGN:<\/jats:title>\n                    <jats:p>A noninferiority randomized controlled trial was designed in which TE-IBR patients received antibiotics either 24 hours postoperatively or until drain removal. The primary outcome was SSI, as defined by CDC criteria. Operative and postoperative protocols were standardized. Secondary endpoints included clinical outcomes up to 1 year and all implant loss, or reoperation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>There were 112 TE-IBR patients (180 breasts) using ADM who were randomized into 2 study arms, with 62 patients in the 24-hour group and 50 in the extended group. Surgical site infection was diagnosed in 12 patients in the 24-hour group and 11 in the extended group (19.4% vs 22.0%, p = 0.82). The extended group had 7 patients who required IV antibiotics and an overall implant loss in 7 patients (14.0%). The 24-hour group had 4 patients who required IV antibiotics, with 3 requiring removal (4.8%). Patients with diabetes, postoperative seroma, or wound dehiscence were all more likely to develop SSI (p &lt; 0.02).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>In a randomized controlled noninferiority trial, 24 hours of antibiotics is equivalent to extended oral antibiotics for SSI in TE-IBR patients. Additional multicenter trials will further assess this important aspect of TE-IBR postoperative care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.jamcollsurg.2016.02.018","type":"journal-article","created":{"date-parts":[[2016,3,5]],"date-time":"2016-03-05T09:40:31Z","timestamp":1457170831000},"page":"1116-1124","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":86,"title":["Are Prophylactic Postoperative Antibiotics Necessary for Immediate Breast Reconstruction? Results of a Prospective Randomized Clinical Trial"],"prefix":"10.1097","volume":"222","author":[{"given":"Brett T.","family":"Phillips","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell S.","family":"Fourman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muath","family":"Bishawi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Zegers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian J.","family":"O'Hea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason C.","family":"Ganz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tara L.","family":"Huston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander B.","family":"Dagum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami U.","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duc T.","family":"Bui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R2-27-20260728","doi-asserted-by":"crossref","first-page":"2265","DOI":"10.1097\/00006534-200206000-00015","article-title":"Complications in postmastectomy breast reconstruction: two-year results of the Michigan Breast Reconstruction Outcome Study","volume":"109","author":"Alderman","year":"2002","journal-title":"Plastic and Reconstructive Surgery"},{"key":"R3-27-20260728","first-page":"e42","article-title":"A systematic review of infection rates and associated antibiotic duration in acellular dermal matrix breast reconstruction","volume":"14","author":"Phillips","year":"2014","journal-title":"Eplasty"},{"key":"R4-27-20260728","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1097\/SAP.0b013e3181dba892","article-title":"The effect of acellular dermal matrix use on complication rates in tissue expander\/implant breast reconstruction","volume":"64","author":"Lanier","year":"2010","journal-title":"Ann Plast Surg"},{"key":"R5-27-20260728","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/j.suc.2007.01.005","article-title":"Complications in breast surgery","volume":"87","author":"Vitug","year":"2007","journal-title":"Surg Clin North Am"},{"key":"R6-27-20260728","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1053\/jinf.2002.1073","article-title":"Nosocomial infection and related risk factors in a general surgery service: a prospective study","volume":"46","author":"Vazquez-Aragon","year":"2003","journal-title":"J Infect"},{"key":"R7-27-20260728","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1097\/01.sap.0000168527.52472.3c","article-title":"Immediate bilateral breast reconstruction with implants and inferolateral AlloDerm slings","volume":"55","author":"Breuing","year":"2005","journal-title":"Ann Plast Surg"},{"key":"R8-27-20260728","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1097\/PRS.0b013e31824a2acb","article-title":"The use of acellular dermal matrix in immediate two-stage tissue expander breast reconstruction","volume":"129","author":"Weichman","year":"2012","journal-title":"Plast Reconstr Surg"},{"issue":"S4","key":"R9-27-20260728","doi-asserted-by":"crossref","first-page":"S201","DOI":"10.1097\/SAP.0000000000000446","article-title":"Effects of immediate reconstruction on adjuvant chemotherapy in breast cancer patients","volume":"74","author":"Eck","year":"2015","journal-title":"Ann Plast Surg"},{"key":"R10-27-20260728","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/PRS.0b013e3182729c39","article-title":"A systematic review of antibiotic use and infection in breast reconstruction: what is the evidence?","volume":"131","author":"Phillips","year":"2013","journal-title":"Plast Reconstr Surg"},{"key":"R11-27-20260728","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1001\/jamasurg.2013.1412","article-title":"Is the elimination of postoperative antimicrobial prophylaxis in thoracic surgery ready for prime time? 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