(0527) Postoperative Infection After Functional Septorhinoplasty: Rates and Risk Factors at a Tertiary Referral Center

Introduction: The use of postoperative antibiotics is best supported after complex SRP, which is typically defined as a revision case or one where grafts or implants are utilized. Tertiary care centers often perform higher rates of complex and revision cases, and there is a paucity of recent data delineating the specific operative factors that predispose a patient to infection after SRP in this setting. Ongoing research is warranted to better characterize the role of postoperative antibiotics after SRP.

Methods: A retrospective study was performed of patients greater than 18 years old who underwent SRP by board-certified facial plastic surgeons at Atrium Health Wake Forest Baptist from 2019-2023. Ultimately, 329 patients met inclusion criteria from 2019-2023. Rates of infections as well as risk factors—including demographic data, operative factors, and postoperative management—were assessed.

Results: Patients undergoing SRP were predominantly Caucasian and middle-aged, with nearly even split between male and female patients. Of patients, 36% had undergone prior nasal surgery, and 7% had prior SRP or rhinoplasty. At discharge after their surgery, 40% received postoperative antibiotics, with Keflex/cephalexin being the most commonly-prescribed medication. Rates of abscess formation were 4.8%. Several patients required hospitalization or re-operation for washout of abscess. When cultures were obtained, drug-resistant bacteria were common. Use of irradiated donor rib for grafting was a statistically significant risk factor for development of postoperative abscess (p = 0.032). Patient factors such as older age and diabetic status did not appear to increase risk for development of infection. Use of postoperative antibiotics was not protective from infection when irradiated rib was implicated.

Conclusions: Rates of postoperative infection after septorhinoplasty remain low. However, when infections occur it is more commonly in the setting of donor rib grafting, and drug-resistant bacteria may be involved. The benefit of antibiotics in the postoperative setting is still not clear.