PERIOPERATIVE ANTIBIOTIC PROPHYLAXIS: PATHOGENETIC REALITIES OF BREAST SURGERY

The objective of the study was to assess the risks of developing wound infection, taking into account the pharmacokinetics of ceftriaxone used as a means of perioperative antibiotic prophylaxis during breast surgery.

Material and methods. 53 patients who had undergone surgery for breast cancer were examined. Verification of ceftriaxone in biological media was performed by capillary electrophoresis (KAPEL-105M; Lumex, St. Petersburg). Laser-Doppler flowmetry (LAKK-02; Russia) was used for microcirculation assessment.

Results and discussion. On the first day after surgery, the wound area had increased microcirculation by rising the maximum amplitude of the endothelial (p=0.049) and myogenic (p=0.037) control factors. On this background, an hour after the administration of ceftriaxone, its maximum content was in the muscle tissue (50,5±9,52 μg/0.1 g). A minimum of the drug was detected in the subcutaneous tissue, which determined the risk of developing a wound infection there.

Conclusion. After a breast cancer surgery, the local status of nutritive channel provides a stable concentration of ceftriaxone in the vulnar zone administered for perioperative antibiotic prophylaxis. The resulting complications (infiltrate, "seroma") have minimal clinical significance.

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