Answer:
Case is clean, hence should not need perioperative antibiotics.
Incidence of wound infection:
1) 2.2% in 899 cases
2) 1 out of 132 (0.7%) without IV antibiotics
0 out of 60 with IV antibiotics
All 192 patients had intraop irrigation of submuscular pocket with bacitracin or betadine.
There is a theory that Staph epidermidis causes capsular contracture as it is found in the glycocalyx biofilm around implants, up to 80% in patients with contracture vs. 20% in patients without contracture.
1) Periop antibiotics, (Pcn and Diclox IV 1 hour before surgery)
Decreased from 79% to 7% positive cultures but did not significantly affect rate of capsular contracture.
2)Intra-luminal antibiotics to promote slow diffusion of antibiotics from capsule does decrease the rate of contracture but doubles the risk of implant deflation.
3) In-pocket irrigation:
bacitracin: <3% contracture
povidine iodine vs saline: 12% had Baker III contracture vs 28% with saline.