Abstract P1-20-09: Does a single-dose of pre-operative prophylactic antibiotic reduce surgical site infection following wire-localized lumpectomy?
Bibliographic record
Abstract
Abstract Background: Data on the benefits of preoperative prophylactic antibiotics for breast surgery are conflicting and there is no guideline for their use for wire-localized lumpectomy. The aims of this study were to determine whether a single dose of pre-operative antibiotic reduces surgical site infection (SSI) for wire-localized lumpectomy and to identify risk factors for SSI. Methods: This was a prospective randomized trial carried out from April 2018 to June 2019 at the “Centre des Maladies du Sein du CHU de Québec - Université Laval”, a tertiary center specialized in breast surgery. After informed consent, patients who underwent wire-localized lumpectomy were randomized to receive or not a pre-operative single dose of prophylactic antibiotic (cefazolin 2 g or clindamycin 900 mg in case of penicillin allergy). Data regarding demographics, comorbidities, perioperative details, and SSI were analyzed. SSI was considered if: 1) patient had positive wound cultures; or 2) required abscess drainage; or 3) received antibiotic treatment for breast symptoms (e.g., important erythema, congestion) within 30 days after operation, in the absence of wound culture or in the presence of negative results. The investigator responsible for data collection was blind to grouping. All patients were called 30 days after surgery to be sure that they did not consult at another hospital for surgical wound infection. Results: A total of 326 patients were enrolled. Eighteen patients were excluded because they retired their consent or because grouping was not respected in the operating room. The two groups were similar for demographic data, perioperative details, and comorbidities. The overall SSI rate was 4.6% (14/308), and more specifically 3.1% (5/159) in the antibiotic group and 6.0% (9/149) in the no antibiotic group (P=0.28). The frequency of having a body mass index >30 kg/m2 was higher among patients with SSI (SSI: 57.1% (8/14); no SSI: 21.8% (64/294); P=0.006). Among the patients with obesity who developed a SSI (n=8), three (37.5%) did receive a prophylactic antibiotic. Age, diabetes, hypertension, smoking, neoadjuvant chemotherapy, history of radiotherapy, past history of chemotherapy, second surgery, ASA ≥3, surgical time >30 min, number of wires, technique for wire insertion, lymph node excision, and oncoplasty were not associated with SSI. All cases of SSI were treated routinely by antibiotic treatment; one patient required wound re-opening. None of the SSI delayed any adjuvant treatment. Conclusion: Our SSI rate (4.6%) for wire-localized lumpectomy is superior to that of the existing literature (2.0-2.3%), but the SSI definitions varied among those previous studies and with the present one. None of the cases was proven by positive cultures (either not done or negative), and overtreatment of a possible SSI is a possibility. The results suggest that it is safe to omit prophylactic antibiotic for wire-localized lumpectomy since it does not seem to reduce SSI significantly. Omitting prophylactic antibiotic could decrease the costs of surgery and avoid side effects. Citation Format: Gabrielle Bergeron Giguère, Brigitte Poirier, Louise Provencher, Dominique Boudreau, Dominique Leblanc, Eric Poirier, Jean-Charles Hogue, Christine Desbiens. Does a single-dose of pre-operative prophylactic antibiotic reduce surgical site infection following wire-localized lumpectomy? [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-20-09.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".