• Max Dieterich, Toralf Reimer, Guenther Kundt, Johannes Stubert, and Bernd Gerber.
• Department of Obstetrics and Gynecology, Breast Unit, University of Rostock, Suedring 81, 18059, Rostock, Germany. max.dieterich@uni-rostock.de
• Aesthetic Plast Surg. 2013 Jun 1;37(3):554-60.

BackgroundSurgical-site infections after reduction mammaplasty are associated with poor cosmetic results. This study investigated the postoperative antiinflammatory influence of hydroxyethyl starch and its effect on surgical-site infections after breast reduction.MethodsIn this prospective case-control study, 334 patients undergoing reduction mammaplasty were prospectively assigned in a 2:1 ratio to receive either 2 × 250 ml of hydroxyethyl starch 6 % or saline solution 0.9 % for 3 days postoperatively. Patient follow-up evaluation was at least 1 month. Using uni- and multivariate analyses, this study aimed to identify risk factors for surgical-site infections and nipple necrosis.ResultsSurgical-site infections occurred in 6.6 % of the hydroxyethyl starch group and in 3.6 % of the control group (p = 0.704). Hydroxyethyl starch had no effect of reducing surgical-site infections [p = 0.212; odds ratio (OR), 0.317; confidence interval (CI), 0.052-1.925]. According to univariate analyses, hydroxyethyl starch reduced the occurrence of postoperative fever (p = 0.085; OR 0.608; CI 0.345-1.072), and fever was associated with increased infection rates (p = 0.033; OR 2.335; CI 1.071-5.089). Additional risk factors for postoperative infections were diabetes (p = 0.051; OR 4.051; CI 0.997-16.463) and obesity (normal weight vs grade ≥2: p = 0.003; OR 7.612; CI 2.031-28.529). Multivariate analysis showed no independent predictors for surgical-site infections. Nipple necrosis were equally observed in the two groups (p = 0.458; OR 1.643; CI 0.443-6.097).ConclusionThe antiinflammatory approach of hydroxyethyl starch did not lead to a decrease in infections or nipple necrosis. No difference in surgical-site infections was observed between aesthetic and oncologic procedures.Level Of Evidence IiiThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

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