Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Postoperative Antibiotic Requirements Following Immediate Breast Reconstruction
Brief Summary: Antibiotics are used routinely in postoperative tissue expander based breast reconstruction (TE) and autologous flap (AF) breast reconstruction procedures. Closed suction drains are also used routinely in immediate breast reconstruction to prevent fluid accumulation and seroma formation at the surgical sites. Antibiotics are most often prescribed as a precaution since drains can be a source for infection by creating open channels to outside contaminants. Plastic surgery patients without closed suction drainage devices are usually not placed on prolonged postoperative antibiotics. Current preoperative surgical antibiotic prophylaxis is recommended for up to 24 hours only. These recommendations do not take into account the increased risk of indwelling closed suction drains. A recent survey of plastic surgeons, conducted by SBUMC investigators, (IRB# 129415) found that Plastic Surgeons are divided as to extended outpatient administration following TE breast reconstruction.

The study plans to prospectively enroll patients who will undergo immediate breast reconstruction with TE or AF based breast reconstruction. Using the above data and the current protocol, the investigators will investigate the optimal antibiotic discontinuation period for these patients. The investigators hypothesize that the use of 24-hour perioperative antibiotics in TE or AF based immediate breast reconstruction with closed suction drainage, does not result in an increased infection rate compared to prolonged postoperative antibiotic administration.


Options:
A: Arm Label: Treatment Arm; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Cefazolin | Arm Label: Placebo Arm; Type: PLACEBO_COMPARATOR; Interventions: Procedure: Sterile water | Intervention Type: PROCEDURE; Name: Cefazolin; Assigned to Arm(s): Treatment Arm | Intervention Type: PROCEDURE; Name: Sterile water; Assigned to Arm(s): Placebo Arm
B: Arm Label: Prophylaxis Group; Type: ACTIVE_COMPARATOR; Interventions: Drug: Ampicillin/Sulbactam | Arm Label: No Prophylaxis Group; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: DRUG; Name: Ampicillin/Sulbactam; Assigned to Arm(s): Prophylaxis Group
C: Arm Label: Antibiotics until Drain Removal; Type: OTHER; Interventions: Drug: Cefadroxil until drain removal | Arm Label: Early discontinuation of antibiotics; Type: EXPERIMENTAL; Interventions: Drug: Cefadroxil discontinued early | Intervention Type: DRUG; Name: Cefadroxil discontinued early; Assigned to Arm(s): Early discontinuation of antibiotics | Intervention Type: DRUG; Name: Cefadroxil until drain removal; Assigned to Arm(s): Antibiotics until Drain Removal
D: Arm Label: Gentamicin lavage; Type: EXPERIMENTAL; Interventions: Drug: Axillary lavage with gentamicin solution | Arm Label: Normal saline lavage; Type: ACTIVE_COMPARATOR; Interventions: Drug: Axillary lavage with gentamicin solution | Intervention Type: DRUG; Name: Axillary lavage with gentamicin solution; Assigned to Arm(s): Gentamicin lavage, Normal saline lavage

Answer: C