Prophylactic antibiotics in plastic surgery: Trends of use over 25 years of an evolving specialty

Abstract

Background: Infection complicating a plastic-surgery procedure can be a catastrophic event, both for the patient and the surgeon. Surveys published in 1975 and 1985 demonstrated the “usual and customary” practices of plastic surgeons with regard to the use of prophylactic antibiotics. Objective: The objective of this study was to determine plastic surgeons' current use of prophylactic antibiotics, to compare these data with similar data from 1975 and 1985, and to gain relevant information regarding newer aesthetic procedures. Methods: We conducted a survey of members of the American Society of Plastic Surgeons to elicit information on the frequency and timing of and modifying influences on their use of prophylactic antibiotics for plastic surgery procedures. The data we compiled were compared with the 1985 and 1975 data. Results: Respondents returned 1804 questionnaires, for a 35% response rate. Antibiotic usage increased by 100% in nearly half of the operative categories surveyed since 1985 (P = .001). Aesthetic procedures were most common in this group. In 7 procedures, usage increased by 200% (P = 0.001). These categories included rhinoplasty, blepharoplasty, rhytidectomy, and arm contouring. Conclusions: The use of prophylactic antibiotics by plastic surgeons is increasing, especially in aesthetic procedures. A review of the literature indicates that this increase in use is not based on scientific evidence of increased incidence of infection or on increased evidence of efficacy. The necessary data to provide scientific guidelines for antibiotic usage in plastic surgery do not exist. (Aesthetic Surg J 2003;23:177-183.)