Do Postoperative Antibiotics Improve Skin Reactivity Following Percutaneous Auditory Osseointegrated Implant Placement

OBJECTIVE: To determine if the routine use of postoperative antibiotics following percutaneous auditory osseointegrated implant placement reduces skin reactivity. STUDY DESIGN: Retrospective matched case-controlled series. SETTINGS: Tertiary academic medical center. SUBJECT AND METHODS: A total of 44 patients who underwent percutaneous auditory osseointegrated implant placement were divided into those who received 5 days of postoperative antibiotics (AB) and those who received no antibiotics (NAB). All surgery was performed using the same surgical technique (Minimally Invasive Ponto Surgery). Variables recorded included patient demographics, Holgers skin reaction score, complications, and need for further intervention. RESULTS: A total of 23 patients received prophylactic postoperative antibiotics (AB) while 21 patients did not (NAB). At the first postoperative visit (AB 12.7 d versus NAB 12.3 d, p = 0.9) there were no differences in average Holgers score (AB 0.3 +/- 0.7 versus NAB 0.2 +/- 0.5, p = 0.27). The odds ratio for skin reactivity at the first visit was 0.11 (95% CI 0.01-2.32). There were also no statistical differences in Holgers score (AB 0.05 +/- 0.2 versus NAB 0.1 +/- 0.3, p = 0.25) at most recent followup visit (AB mean 97.5 d versus NAB 102.8 d, p = 0.84). The odds ratio for skin reactivity at the most recent visit was 0.16 (95% CI 0.01-3.64). CONCLUSIONS: The use of postoperative antibiotics does not appear to confer significant difference in skin reactivity in patients receiving percutaneous osseointegrated auditory implants. Such findings support the theory that skin reactivity, when it does occur, may not be an infectious-mediated process.