Antibiotic Prophylaxis in Plastic Surgery Procedures: Indications, Organisms Involved, Medications and Treatment Duration

Introduction: Antibiotic prophylaxis has been less extensively studied in plastic surgery and specifications of the ideal duration and types of antibiotics are often not specified. Very few studies have been carried out looking at optimal use of antibiotic prophylaxis and the practice of antibiotic prophylaxis is largely dependent on physician preference and individual knowledge. Methods: We have formulated four practical questions relevant for the daily plastic surgery practice and evaluated the scientific evidence to formulate answers to these questions using the medical database of the National Library of Medicine (Pubmed.gov®) • What are the indications for antibiotic prophylaxis in plastic surgery? • Which organisms are involved in postoperative plastic surgery infections? • Which prophylactic antibiotics in which dose should be used? • What is the duration of prophylactic antibiotic use? Results: A single dose first-generation cephalosporin such as cefazolin or ampicillin-sulbactam shows the lowest infections rate. Antibiotics are indicated in clean plastic surgery procedures with high-risk factors and in clean-contaminated or contaminated procedures. A short-course administration regimen seemed to be of adequate efficacy and safety. Conclusion: There is an indication for surgical prophylaxis in clean plastic surgery procedures with high-risk factors and in clean-contaminated or contaminated procedures. A short-course administration regimen seemed to be of adequate efficacy and safety. High-quality prospective trials on larger scale are needed to further confirm these findings.