A systematic review of infection rates and associated antibiotic duration in acellular dermal matrix breast reconstruction.


Journal Article

INTRODUCTION: Reported infection rates in breast reconstruction with acellular dermal matrix (ADM) can exceed 31%. Prophylactic antibiotics remain controversial due to the absence of evidence-based literature. The purpose of this study was to examine published antibiotic regimens and their associated infection rates in this population. METHODS: Systematic electronic searches were performed in PubMed, OVID, and the Cochrane databases for studies that reported on prophylactic antibiotic use and infection in patients undergoing ADM breast reconstruction. Two independent authors reviewed studies between 1970 and 2012 for inclusion and data extraction. RESULTS: A total of 863 studies were identified and abstracts reviewed. A total of 24 articles were included, with 2148 patients and 3189 ADM reconstructions. Mean infection rates varied between 0% and 31.25%, with a combined average of 11.59%. When comparing antibiotic protocols of less than 24 hours and more than 24 hours, the average infection rate was 2.48% and 13.21%, respectively. CONCLUSION: The current literature lacks consensus on the necessary duration for postoperative antibiotic prophylaxis following breast reconstruction. The potential increased risk of infection associated with ADM remains controversial. Because of the lack of supportive evidence, we do not recommend prolonged postoperative antibiotics in ADM breast reconstruction. LEVEL OF EVIDENCE: Therapeutic level III evidence.

Full Text

Duke Authors

Cited Authors

  • Phillips, BT; Bishawi, M; Dagum, AB; Bui, DT; Khan, SU

Published Date

  • January 2014

Published In

Volume / Issue

  • 14 /

Start / End Page

  • e42 -

PubMed ID

  • 25525481

Pubmed Central ID

  • 25525481

Electronic International Standard Serial Number (EISSN)

  • 1937-5719

International Standard Serial Number (ISSN)

  • 1937-5719


  • eng