Uso de antibióticos em mamoplastia redutora no Brasil: inquérito nacional
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Data
2022-12-06
Autores
Kuhnen, Ricardo Beckhauser [UNIFESP]
Orientadores
Veiga, Daniela Francescato [UNIFESP]
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
INTRODUÇÃO: Embora existam evidências limitadas sobre o uso de antibióticos profiláticos em mamoplastia redutora, muitos cirurgiões plásticos os prescrevem, mesmo no pós-operatório. OBJETIVO: Realizar uma revisão da literatura e um inquérito nacional sobre a rotina de prescrição de antibioticoprofilaxia em mamoplastia redutora de cirurgiões plásticos que atuam no Brasil. MÉTODOS: Uma pesquisa anônima composta por 19 questões foi enviada eletronicamente a todos os 4.864 membros ativos da Sociedade Brasileira de Cirurgia Plástica (SBCP). Os dados foram compilados e submetidos à análise estatística. RESULTADOS: A taxa de resposta ao inquérito foi de 17,7% (859 cirurgiões). Apenas 0,5% dos respondentes relataram não prescrever antibióticos em nenhum momento (IC 95%: 0,0–0,9); 9,9% (IC 95%: 7,9–11,9) prescrevem apenas no pré-operatório; e 14,6 % (IC 95%: 12,2–16,9) prescrevem antibióticos por 24 horas. A maioria (75,1%) dos respondentes (IC 95%: 72,1–77,9) prescreve antibióticos por dias adicionais após a alta. Houve associações significativas entre prescrição de antibióticos e faixa etária (p=0,015), tempo de graduação (p<0,001), experiência na prática da especialidade (p=0,003), tipo de filiação à SBCP (p<0,001) e taxas de infecção de sítio cirúrgico (p=0,011). CONCLUSÃO: A maioria dos cirurgiões plásticos respondentes relatou prescrever antibióticos por mais de 24 horas após mamoplastias redutoras.
BACKGROUND: Although there is limited evidence for regulating the use of prophylactic antibiotics in reduction mammoplasty, many plastic surgeons prescribe them, even in the postoperative period. OBJECTIVE: Conduct a literature review and a survey to investigate the antibiotic prophylaxis protocols conducted by Brazilian plastic surgeons in reduction mammoplasty. METHODS: The strategies allowed retrieving 1,838 references, 1,672 were excluded because they weren’t related to the breast reduction. After reading the abstracts, we selected 59. An anonymous survey comprising 19 questions was sent to all 4864 active members of the Brazilian Society of Plastic Surgery (SBCP). The surgeons received the invitation to participate in the survey and the link to fill out the electronic form via e-mail. The data were compiled and subjected to statistical analysis. RESULTS: In total, 859 surgeons (17.7%) responded. Most respondents (77.8%) were male and aged 35–55 years (61.5%), and 58.6% had 10–29 years of specialty training. Only 0.5% reported not prescribing antibiotics at any time (95% CI: 0.0–0.9), 9.9% (95% CI: 7.9–11.9) prescribed them only preoperatively, and 14.6% (95% CI: 12.2–16.9) prescribed continued antibiotic use for 24 hours. Majority (75.1%; 95% CI: 72.1–77.9) prescribed antibiotics for additional days after discharge. There were significant associations between antibiotic prescription and the age group (p=0.015), time since graduation (p<0.001), experience in the specialty practice (p=0.003), SBCP membership (p<0.001), and surgical site infection rates (p=0.011). CONCLUSIONS: Most responding plastic surgeons affirmed that they prescribe prophylactic antibiotics for more than 24 hours in reduction mammoplasty cases.
BACKGROUND: Although there is limited evidence for regulating the use of prophylactic antibiotics in reduction mammoplasty, many plastic surgeons prescribe them, even in the postoperative period. OBJECTIVE: Conduct a literature review and a survey to investigate the antibiotic prophylaxis protocols conducted by Brazilian plastic surgeons in reduction mammoplasty. METHODS: The strategies allowed retrieving 1,838 references, 1,672 were excluded because they weren’t related to the breast reduction. After reading the abstracts, we selected 59. An anonymous survey comprising 19 questions was sent to all 4864 active members of the Brazilian Society of Plastic Surgery (SBCP). The surgeons received the invitation to participate in the survey and the link to fill out the electronic form via e-mail. The data were compiled and subjected to statistical analysis. RESULTS: In total, 859 surgeons (17.7%) responded. Most respondents (77.8%) were male and aged 35–55 years (61.5%), and 58.6% had 10–29 years of specialty training. Only 0.5% reported not prescribing antibiotics at any time (95% CI: 0.0–0.9), 9.9% (95% CI: 7.9–11.9) prescribed them only preoperatively, and 14.6% (95% CI: 12.2–16.9) prescribed continued antibiotic use for 24 hours. Majority (75.1%; 95% CI: 72.1–77.9) prescribed antibiotics for additional days after discharge. There were significant associations between antibiotic prescription and the age group (p=0.015), time since graduation (p<0.001), experience in the specialty practice (p=0.003), SBCP membership (p<0.001), and surgical site infection rates (p=0.011). CONCLUSIONS: Most responding plastic surgeons affirmed that they prescribe prophylactic antibiotics for more than 24 hours in reduction mammoplasty cases.