Product Description

This study evaluated whether extended postoperative oral antibiotic prophylaxis reduces infectious complications after immediate implant-based postmastectomy breast reconstruction. In 1,687 reconstructed breasts, extended antibiotics did not significantly reduce surgical-site infection, readmission, unplanned reoperation, or explantation after adjustment for patient and operative factors. Higher body mass index, greater mastectomy weight, and prior radiation were associated with increased infection risk, whereas extended antibiotic use was associated with a substantially greater proportion of Gram-negative infections. Extended prophylaxis also produced measurable adverse effects, including allergic reactions and Clostridium difficile colitis. These findings support limiting unnecessary postoperative antibiotics and incorporating antimicrobial stewardship principles into the care of patients undergoing prosthetic breast reconstruction.

Intended Audience

This educational activity is intended for plastic surgery practitioners, residents, and other healthcare professionals interested in translating expanded knowledge into practice for the improvement of patient outcomes in plastic and reconstructive surgery.

Learning Objectives

After viewing this course, the participant should be able to:

1. Describe the effect of extended postoperative oral antibiotic prophylaxis on surgical-site infection, readmission, reoperation, and explantation after immediate prosthetic postmastectomy breast reconstruction.
2. Identify patient and operative factors independently associated with surgical-site infection and implant explantation after immediate prosthetic breast reconstruction.
3. Compare the microbiology of postoperative infections among patients who did and did not receive extended antimicrobial prophylaxis.
4. Recognize adverse events associated with extended oral antibiotic prophylaxis, including allergic reactions and Clostridium difficile colitis.
5. Apply the study findings to postoperative antibiotic decision-making and antimicrobial stewardship after implant-based breast reconstruction.

Faculty:

Mark Sisco, MD; Kristine Kuchta, MS; Duanny Alva, MD, MPH; Akhil K. Seth, MD

Plastic and Reconstructive Surgery Editors

Editor-in-Chief: Kevin C. Chung, MD

Co-editor: Amy S. Colwell, MD

CME Faculty:

Mary Lester, MD

David Light, MD

Accreditation

The American Society of Plastic Surgeons (ASPS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation

The ASPS designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AMA PRA Category 1 Credit™: 1.0

Media: Journal Article

Release Date: 9/14/2026

Expiration Date: 9/14/2029*

Estimated time to complete this course: 1 hour

*Course access ends on course expiration date

Disclosure Policy

The American Society of Plastic Surgeons (ASPS) requires all instructors, planners, reviewers, managers and other individuals in a position to control or influence the content of an activity to disclose all relevant financial relationships or affiliations. All identified conflicts of interest must be resolved and the educational content thoroughly vetted by ASPS for fair balance, scientific objectivity and appropriateness of patient care recommendations. ASPS also requires faculty/authors to disclose when off-label/unapproved uses of product are discussed in a CME activity or included in related materials.

Disclaimer: All relevant financial relationships for planners, faculty and others in control of content (either individually or as a group) are reviewed by the ASPS Continuing Education Committee and have been mitigated, if applicable.

The following planners/faculty members/reviewers have the following disclosures:

Mark Sisco, MD is an advisor for and equity holder in Surgical Innovation Associates, Inc. 

The following planners and faculty members have no relevant financial relationships or affiliations to disclose:

Kristine Kuchta, MS

Duanny Alva, MD, MPH

Akil K. Seth, MD

Mary Lester, MD

David Light, MD

Recognition Statement

The Continuing Medical Education (CME) credits offered by this activity are enhanced by ASPS Learner Credit Reporting for learners who have opted into this reporting. Successful completion of this CME activity enables active American Board of Surgery (ABS) members the opportunity to earn credit toward the CME requirement of the ABS's Continuous Certification program when claimed within 30 days of completion of the activity.

Directly provided by the American Society of Plastic Surgeons® (ASPS®)

Participants in ASPS-accredited education who want their CME credits reported to certifying and state licensing boards must opt-in to reporting and add their NPI as well as state license ID and/or collaborating board ID(s) before claiming credit.

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