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Dressing Wear Time after Breast Reconstruction: A Randomized Clinical Trial
Daniela Francescato Veiga1,2, Carlos Américo Veiga Damasceno3, Joel Veiga-Filho2
1Division of Plastic Surgery, Department of Surgery, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil.
Background:
The evidence to support dressing standards for breast surgery wounds is empiric and scarce.
Objective:
This two-arm randomized clinical trial was designed to assess the effect of dressing wear time on surgical site infection (SSI) rates, skin colonization and patient perceptions.
Methods:
A total of 200 breast cancer patients undergoing breast reconstruction were prospectively enrolled. Patients were randomly allocated to group I (dressing removed on the first postoperative day, n = 100) or group II (dressing removed on the sixth postoperative day, n = 100). SSIs were defined and classified according to criteria from the Centers for Disease Control and Prevention. Samples collected before placing the dressing and after 1 day (group I) and 6 days (both groups) were cultured for skin colonization assessments. Patients preferences and perceptions with regard to safety, comfort and convenience were recorded and analyzed.
Results:
A total of 186 patients completed the follow-up. The global SSI rate was 4.5%. Six patients in group I and three in group II had SSI (p = 0.497). Before dressing, the groups were similar with regard to skin colonization. At the sixth day, there was a higher colonization by coagulase-negative staphylococci in group I (p<0.0001). Patients preferred to keep dressing for six days (p<0.0001), and considered this a safer choice (p<0.05).
Conclusions:
Despite group I had a higher skin colonization by coagulase-negative staphylococci on the sixth postoperative day, there was no difference in SSI rates. Patients preferred keeping dressing for six days and considered it a safer choice.
Trial Registration:
ClinicalTrials.gov NCT01148823.
