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Surgical site infections in breast surgery: case-control study
Diana Vilar-Compte1, Benedicte Jacquemin, Carlos Robles-Vidal
1Department of Infectious Diseases, Instituto Nacional de Cancerología, Avenida San Fernando 22, Col. Sección 16, Tlalpan, 14080 México, DF, México. diana_vilar@yahoo.com.mx
World Journal of Surgery
|February 13, 2004
Summary
Surgical site infections (SSIs) after breast surgery were frequent, especially for mastectomies. Obesity, radical surgery, and prolonged drainage were key risk factors, highlighting the need for improved infection control.
Area of Science:
- Oncology
- Infectious Diseases
- Surgical Outcomes
Background:
- Surgical site infections (SSIs) are a significant complication following breast cancer surgery.
- Estimating SSI frequency and identifying specific risk factors is crucial for improving patient outcomes.
Purpose of the Study:
- To determine the incidence of SSIs across different types of breast surgery.
- To identify independent risk factors associated with SSIs in breast cancer patients.
Main Methods:
- A nested case-control study design was employed.
- Data collected from 280 patients (298 wounds) undergoing breast surgery between February and July 2000.
- Logistic regression analysis was used to estimate odds ratios for risk factors.
Main Results:
- The overall SSI rate was 25.8%, with rates of 1.4% for excisions, 18.0% for conservative surgery, and 38.3% for radical mastectomies.
- Independent risk factors included obesity, concomitant chemotherapy and radiation, radical surgery, insertion of a second drain, and drainage duration of 19 days or more.
- Pseudomonas aeruginosa and Serratia sp. were the most common pathogens identified.
Conclusions:
- Breast surgery, particularly radical mastectomy, is associated with a high SSI rate.
- Obesity, advanced disease requiring radical surgery, and suboptimal wound/drain management contribute to increased SSI risk.
- Enhanced adherence to infection control practices and wound management protocols is essential.
