BACKGROUND: Reported surgical site infection (SSI) rates after breast operations ranges 0.8-26 % in the literature. The aims of the present study were to characterize SSI after breast/axillary operations and determine the impact on the SSI rate of the 2010 Centers for Disease Control and Prevention (CDC) reporting guidelines that now specifically exclude cellulitis. METHODS: Retrospective chart review identified 368 patients with 449 operated sides between July 2004 and June 2006. SSI was defined by CDC criteria: purulent drainage (category 1), positive aseptically collected culture (category 2), signs of inflammation with opening of incision and absence of negative culture (category 3), and physician diagnosis of infection (category 4). The impact of excluding cellulitis was assessed. RESULTS: Prior CDC reporting guidelines revealed that among 368 patients, 32 (8.7 %) experienced SSI in 33 (7.3 %) of 449 operated sides. Of these, 11 (33 %) met CDC criteria 1-3, while 22 (67 %) met CDC criterion 4. Excluding cellulitis cases per 2010 CDC SSI reporting guidelines eliminates 21 of the 22 infections previously meeting CDC criterion 4. Under the new reporting guidelines, the SSI rate is 12 (2.7 %) of 449 operated sides. SSI rates varied by procedure, but these differences were not statistically significant. CONCLUSIONS: Cellulitis after breast and axillary surgery is much more common than other criteria for SSI, and SSI rates are reduced almost threefold if cellulitis cases are excluded. Recently revised CDC reporting guidelines may result in underestimates of the clinical burden of SSI after breast/axillary surgery.
BACKGROUND: Reported surgical site infection (SSI) rates after breast operations ranges 0.8-26 % in the literature. The aims of the present study were to characterize SSI after breast/axillary operations and determine the impact on the SSI rate of the 2010 Centers for Disease Control and Prevention (CDC) reporting guidelines that now specifically exclude cellulitis. METHODS: Retrospective chart review identified 368 patients with 449 operated sides between July 2004 and June 2006. SSI was defined by CDC criteria: purulent drainage (category 1), positive aseptically collected culture (category 2), signs of inflammation with opening of incision and absence of negative culture (category 3), and physician diagnosis of infection (category 4). The impact of excluding cellulitis was assessed. RESULTS: Prior CDC reporting guidelines revealed that among 368 patients, 32 (8.7 %) experienced SSI in 33 (7.3 %) of 449 operated sides. Of these, 11 (33 %) met CDC criteria 1-3, while 22 (67 %) met CDC criterion 4. Excluding cellulitis cases per 2010 CDC SSI reporting guidelines eliminates 21 of the 22 infections previously meeting CDC criterion 4. Under the new reporting guidelines, the SSI rate is 12 (2.7 %) of 449 operated sides. SSI rates varied by procedure, but these differences were not statistically significant. CONCLUSIONS:Cellulitis after breast and axillary surgery is much more common than other criteria for SSI, and SSI rates are reduced almost threefold if cellulitis cases are excluded. Recently revised CDC reporting guidelines may result in underestimates of the clinical burden of SSI after breast/axillary surgery.
Authors: Jonathan R Edwards; Kelly D Peterson; Yi Mu; Shailendra Banerjee; Katherine Allen-Bridson; Gloria Morrell; Margaret A Dudeck; Daniel A Pollock; Teresa C Horan Journal: Am J Infect Control Date: 2009-12 Impact factor: 2.918
Authors: Robert E Mansel; Lesley Fallowfield; Mark Kissin; Amit Goyal; Robert G Newcombe; J Michael Dixon; Constantinos Yiangou; Kieran Horgan; Nigel Bundred; Ian Monypenny; David England; Mark Sibbering; Tholkifl I Abdullah; Lester Barr; Utheshtra Chetty; Dudley H Sinnett; Anne Fleissig; Dayalan Clarke; Peter J Ell Journal: J Natl Cancer Inst Date: 2006-05-03 Impact factor: 13.506
Authors: Eva Ruvalcaba-Limón; Carlos Robles-Vidal; Adela Poitevin-Chacón; Mariana Chávez-Macgregor; Carlos Gamboa-Vignolle; Diana Vilar-Compte Journal: Breast Cancer Res Treat Date: 2005-12-01 Impact factor: 4.872
Authors: E Prospero; A Cavicchi; S Bacelli; P Barbadoro; L Tantucci; M M D'Errico Journal: Infect Control Hosp Epidemiol Date: 2006-11-21 Impact factor: 3.254
Authors: Daniel Indelicato; Stephen R Grobmyer; Heather Newlin; Christopher G Morris; Linda S Haigh; Edward M Copeland; Nancy Price Mendenhall Journal: Surgery Date: 2007-05 Impact factor: 3.982
Authors: Jens Hachenberg; Christian Eichler; Ellen Acis; Maximilian Mattes Auer-Schmidt; Mathias Warm; Wolfram Malter; Fabinshy Thangarajah Journal: In Vivo Date: 2021 Jan-Feb Impact factor: 2.155
Authors: Soo Yeon Baek; Jisun Kim; Il Yong Chung; Beom Seok Ko; Hee Jeong Kim; Jong Won Lee; Byung Ho Son; Sei-Hyun Ahn; Sae Byul Lee Journal: Breast Cancer Res Treat Date: 2020-09-15 Impact factor: 4.872
Authors: Shitanshu Uppal; John Harris; Ahmed Al-Niaimi; Carolyn W Swenson; Mark D Pearlman; R Kevin Reynolds; Neil Kamdar; Ali Bazzi; Darrell A Campbell; Daniel M Morgan Journal: Obstet Gynecol Date: 2016-02 Impact factor: 7.661
Authors: Florian Ebner; Niko deGregorio; Elena Vorwerk; Wolfgang Janni; Achim Wöckel; Dominic Varga Journal: Breast Care (Basel) Date: 2014-05 Impact factor: 2.860
Authors: Amy C Degnim; Jeffrey S Scow; Tanya L Hoskin; Joyce P Miller; Margie Loprinzi; Judy C Boughey; James W Jakub; Alyssa Throckmorton; Robin Patel; Larry M Baddour Journal: Ann Surg Date: 2013-08 Impact factor: 12.969
Authors: Margaret A Olsen; Kelly E Ball; Katelin B Nickel; Anna E Wallace; Victoria J Fraser Journal: Infect Control Hosp Epidemiol Date: 2016-12-15 Impact factor: 3.254