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Prophylactic Absorbable Antibiotic Beads: Effect on Postoperative Drain Management following Breast Reconstruction
Shahnur Ahmed, MD, John P. Hajj, BS, Ravinder Bamba, MD, Rachel M. Danforth, MD, R. Jason VonDerHaar, MD, Mary E. Lester, MD, Aladdin H. Hassanein, MD, MMSc
Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, IN
2025-01-09
Presenter: Shahnur Ahmed, MD
Affidavit:
All of the work on this project represents the original work of the resident and co-residents
Director Name: E. Matthew Ritter
Author Category: Other Specialty Resident
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background:
Infection is common in postmastectomy tissue expander (TE) reconstruction with reported rates up to 24%. Absorbable antibiotic beads have been shown to reduce TE infection rates when delivered at the time of immediate prepectoral breast reconstruction. It is unknown if the absorbable antibiotic beads prolong drain duration as they resorb. The purpose of this study to evaluate the effect of prophylactic absorbable antibiotic beads on postoperative drain management following immediate postmastectomy TE reconstruction to guide patient counseling and surgical decision-making.
Methods:
A single-center retrospective review was performed for patients who underwent mastectomy, immediate prepectoral TE reconstruction on the same day (2019-2024). Patients were divided into two groups: Group 1 (antibiotic beads with TE placement) and Group 2 (no antibiotic beads with TE). All patients had one drain per reconstructed breast. The average time to postoperative drain removal was the variable of interest.
Results:
The study included 325 patients (548 TEs) who underwent immediate prepectoral TE breast reconstruction postmastectomy and had postoperative drain removal. Group 1 had 36 patients (68 TEs) and Group 2 had 289 patients (480 TEs). The average time to drain removal in days was 17.2±5.6 in Group 1 compared to 17.5±7.5 in Group 2 (p=0.7933). The mean follow-up time was 255 days.
Conclusion:
Patients who receive prophylactic absorbable antibiotic beads during immediate TE reconstruction experience a similar time to drain removal compared to the control group. Patients may be counseled that the use of prophylactic absorbable antibiotic beads does not lengthen drain time when used non-selectively for all patients.
