AIMS AND OBJECTIVES: To study risks of surgical site infection in breast surgery. The objectives were to measure the association of postoperative infection with patient- and procedure-related factors. BACKGROUND: The infection rate in breast surgery is expected to be low but it varies a lot. The variation is recommended to be assessed by measuring procedure-related factors. DESIGN: A retrospective chart review of 982 breast surgery patients was completed. METHODS: The data on patient demographics, procedure types, patient and surgery-related factors were collected. A multivariate logistic regression model for all breast operations (n=982), lumpectomies (n=700) and mastectomies (n=282) was performed. RESULTS: The infection rate was 6.7%. In a multivariate logistic regression model for all operations, a contaminated or dirty wound, high American Society of Anesthesiologists score, high body mass index, use of surgical drains and re-operation predicted increased infection risk. In lumpectomies high body mass index and use of surgical drains predicted increased risk. In mastectomies, the significant predictor was re-operation. CONCLUSIONS: The surgical site infection rate was high. In addition to the two classical risks (high wound class and anaesthesia risk), high body mass index, re-operation and use of surgical drain increased the infection risk among all patients. RELEVANCE TO CLINICAL PRACTICE: In breast surgery careful assessment, documentation and adherence to aseptic practices are important with all patients. Patients with heavy weight need special attention. The need for antimicrobial prophylaxis in re-operations and the need of surgical drains in lumpectomies are important to consider carefully.
AIMS AND OBJECTIVES: To study risks of surgical site infection in breast surgery. The objectives were to measure the association of postoperative infection with patient- and procedure-related factors. BACKGROUND: The infection rate in breast surgery is expected to be low but it varies a lot. The variation is recommended to be assessed by measuring procedure-related factors. DESIGN: A retrospective chart review of 982 breast surgery patients was completed. METHODS: The data on patient demographics, procedure types, patient and surgery-related factors were collected. A multivariate logistic regression model for all breast operations (n=982), lumpectomies (n=700) and mastectomies (n=282) was performed. RESULTS: The infection rate was 6.7%. In a multivariate logistic regression model for all operations, a contaminated or dirty wound, high American Society of Anesthesiologists score, high body mass index, use of surgical drains and re-operation predicted increased infection risk. In lumpectomies high body mass index and use of surgical drains predicted increased risk. In mastectomies, the significant predictor was re-operation. CONCLUSIONS: The surgical site infection rate was high. In addition to the two classical risks (high wound class and anaesthesia risk), high body mass index, re-operation and use of surgical drain increased the infection risk among all patients. RELEVANCE TO CLINICAL PRACTICE: In breast surgery careful assessment, documentation and adherence to aseptic practices are important with all patients. Patients with heavy weight need special attention. The need for antimicrobial prophylaxis in re-operations and the need of surgical drains in lumpectomies are important to consider carefully.
Authors: Margaret A Olsen; Katelin B Nickel; Julie A Margenthaler; Anna E Wallace; Daniel Mines; J Philip Miller; Victoria J Fraser; David K Warren Journal: Ann Surg Oncol Date: 2014-10-31 Impact factor: 5.344
Authors: F A Salem; M Almquist; E Nordenström; J Dahlberg; O Hessman; C I Lundgren; A Bergenfelz Journal: World J Surg Date: 2018-08 Impact factor: 3.352