Grants Funded
ASPS/PSF leadership is committed to continuing to provide high levels of investigator-initiated research support to ensure that plastic surgeons have the needed research resources to be pioneers and innovators in advancing the practice of medicine.
Research Abstracts
Search The PSF database to have easy access to full-text grant abstracts from past PSF-funded research projects 2003 to present. All abstracts are the work of the Principal Investigators and were retrieved from their PSF grant applications. Several different filters may be applied to locate abstracts specific to a particular focus area or PSF funding mechanism.
Dissemination and Implementation of Tissue Expander Antibiotic Guidelines
Principal Investigator
Kimberly Khoo MD
Kimberly Khoo MD
Year
2025
2025
Institution
Johns Hopkins University School of Medicine
Johns Hopkins University School of Medicine
Funding Mechanism
Focus Area
Abstract
Project Summary
Tissue expander-based reconstruction (TE-BR) is the most commonly performed breast reconstruction procedure. However, a common and devastating complication of TE-BR is infection, and infection rates in TE-BR are substantially higher than those in other
surgical procedures in the United States. Antibiotics are often used to treat infections in tissue expanders, but no current guidelines exist regarding whether antibiotics should be prescribed for infection prevention in TE-BR. This lack of a standardized guideline has led to varying prescribing practices for plastic surgeons, resulting in unnecessary medical
treatment and possibly contributing to higher rates of antibiotic resistance. Multiple studies have shown no significant difference in infection rates between patients whose antibiotics courses were discontinued within 24 hours of surgery and those who received a
longer course of postoperative antibiotics in TE-BR. Global organizations such as the World Health Organization (WHO) and the Centers for Disease Control (CDC) also recommend discontinuing antibiotics within 24 hours of surgery. This issue illustrates the challenge of translating research into clinical practice. The emerging fields of dissemination and implementation (D&I) sciences aim to address this challenge by studying how information is distributed and how evidence-based interventions can be adopted into practice.
The authors of this study will conduct a dissemination and implementation (D&I) trial across three different academic institutions to identify barriers to adopting evidence-based antibiotic guidelines in TE-BR. By surveying and interviewing plastic surgeons who
perform TE-BR, the authors seek to understand why surgeons continue to prescribe antibiotics beyond 24 hours and whether they are aware of existing guidelines that recommend against this practice. Additionally, the authors will create specific implementation strategies to address challenges in incorporating the antibiotic guidelines into routine practice.
Impact Statement
This proposal aims to improve the uptake of evidence-based guidelines to guide antibiotic use in tissue expander-based breast reconstruction and to increase the translation of plastic surgery research into practice. Multiple studies have shown that continuing antibiotic courses beyond 24 hours in tissue expander-based breast reconstruction does not reduce the risk of infections. Yet, there is
no clear guidance on implementing this in real-world settings. This project will explore barriers to adopting this evidence and develop strategies to overcome them. It is one of the first to apply dissemination and implementation sciences to the field of plastic
surgery, aiming to accelerate the process of turning scientific findings into practical guidance that can directly benefit patients.
Project Summary
Tissue expander-based reconstruction (TE-BR) is the most commonly performed breast reconstruction procedure. However, a common and devastating complication of TE-BR is infection, and infection rates in TE-BR are substantially higher than those in other
surgical procedures in the United States. Antibiotics are often used to treat infections in tissue expanders, but no current guidelines exist regarding whether antibiotics should be prescribed for infection prevention in TE-BR. This lack of a standardized guideline has led to varying prescribing practices for plastic surgeons, resulting in unnecessary medical
treatment and possibly contributing to higher rates of antibiotic resistance. Multiple studies have shown no significant difference in infection rates between patients whose antibiotics courses were discontinued within 24 hours of surgery and those who received a
longer course of postoperative antibiotics in TE-BR. Global organizations such as the World Health Organization (WHO) and the Centers for Disease Control (CDC) also recommend discontinuing antibiotics within 24 hours of surgery. This issue illustrates the challenge of translating research into clinical practice. The emerging fields of dissemination and implementation (D&I) sciences aim to address this challenge by studying how information is distributed and how evidence-based interventions can be adopted into practice.
The authors of this study will conduct a dissemination and implementation (D&I) trial across three different academic institutions to identify barriers to adopting evidence-based antibiotic guidelines in TE-BR. By surveying and interviewing plastic surgeons who
perform TE-BR, the authors seek to understand why surgeons continue to prescribe antibiotics beyond 24 hours and whether they are aware of existing guidelines that recommend against this practice. Additionally, the authors will create specific implementation strategies to address challenges in incorporating the antibiotic guidelines into routine practice.
Impact Statement
This proposal aims to improve the uptake of evidence-based guidelines to guide antibiotic use in tissue expander-based breast reconstruction and to increase the translation of plastic surgery research into practice. Multiple studies have shown that continuing antibiotic courses beyond 24 hours in tissue expander-based breast reconstruction does not reduce the risk of infections. Yet, there is
no clear guidance on implementing this in real-world settings. This project will explore barriers to adopting this evidence and develop strategies to overcome them. It is one of the first to apply dissemination and implementation sciences to the field of plastic
surgery, aiming to accelerate the process of turning scientific findings into practical guidance that can directly benefit patients.
Biography
Kimberly Khoo, MD MPH is a current Research Fellow in the Department of Plastic and Reconstructive Surgery at Johns Hopkins. She was born and raised in Sugar Land, Texas, then obtained her biology degree from the University of Texas at Austin. She then went on to pursue her medical degree from the University of Texas Medical Branch at Galveston. In between her third and fourth years of medical school, Dr. Khoo attended the Johns Hopkins Bloomberg School of Public Health, where she received her Master of Public Health degree with a certificate in Health Disparities and Inequities. She also pursued a translational research year with the Hopkins
Peripheral Nerve Lab. Her clinical interests lie in hand surgery, microsurgery, breast, and gender-affirming surgery, and her research focuses on health disparities, health services research, and patient-centered outcomes research.
Kimberly Khoo, MD MPH is a current Research Fellow in the Department of Plastic and Reconstructive Surgery at Johns Hopkins. She was born and raised in Sugar Land, Texas, then obtained her biology degree from the University of Texas at Austin. She then went on to pursue her medical degree from the University of Texas Medical Branch at Galveston. In between her third and fourth years of medical school, Dr. Khoo attended the Johns Hopkins Bloomberg School of Public Health, where she received her Master of Public Health degree with a certificate in Health Disparities and Inequities. She also pursued a translational research year with the Hopkins
Peripheral Nerve Lab. Her clinical interests lie in hand surgery, microsurgery, breast, and gender-affirming surgery, and her research focuses on health disparities, health services research, and patient-centered outcomes research.