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Incidence and Predisposing Factors of Postoperative Infection after Rhinoplasty: A Single Surgeon's 16-Year
Khanh Ngoc Tran1, Yong Ju Jang1
1From the Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, College of Medicine, University of Ulsan.
Background:
This study evaluated the incidence and clinical characteristics of postoperative infection following rhinoplasty.
Methods:
This article is a retrospective review of 2630 East Asian rhinoplasty cases performed by a single surgeon (Y.J.J.), from July of 2003 to June of 2018. There were 1595 male patients (69.9 percent) and 687 female patients (30.1 percent), and the median age was 31 years. The incidence of infection was compared between primary and revision cases and analyzed according to the materials used. The authors evaluated the organisms cultured and the timeframe of infection development and intervention.
Results:
There were 2134 primary and 496 revision cases. Materials included autologous costal cartilage (413 cases), conchal cartilage (572 cases), homologous fascia lata (829 cases), homologous costal cartilage (102 cases), Gore-Tex (373 cases), and silicone (32 cases). The authors identified 22 cases (0.84 percent) of postoperative infection, 18 of which were revision. Revision surgery had a 19-fold greater infection rate than primary surgery (3.63 percent versus 0.19 percent). Women were 3.6 times as likely to develop an infection ( p = 0.002). The infection rate using autologous costal cartilage was 3.39 percent, and that for simultaneous correction of a septal perforation was 8.57 percent. In 11 cases (50 percent), infection developed within 1 month after surgery (12 ± 7 days). Methicillin-resistant Staphylococcus aureus was cultured in eight cases. Infection manifested at the nasal tip in 45 percent and the caudal septum/columella in 32 percent of cases. Twenty cases (90.9 percent) underwent surgical débridement.
Conclusion:
Revision rhinoplasty in women, requiring the use of costal cartilage or simultaneous correction of septal perforation, showed a higher risk of postrhinoplasty infection, which usually manifested at the nasal tip and caudal septum/columella and needed to be managed by surgical débridement.
Clinical Question/Level Of Evidence:
Therapeutic, IV.
Insights
Revision rhinoplasty significantly increases infection risk, especially in women using costal cartilage or correcting septal perforations. Infections typically appear at the nasal tip and septum, requiring surgical débridement.
Area of Science:
- Plastic Surgery
- Infectious Disease Epidemiology
Background:
- Postoperative infection is a potential complication of rhinoplasty.
- Understanding risk factors is crucial for prevention and management.
Purpose of the Study:
- To evaluate the incidence and clinical characteristics of postoperative infection following rhinoplasty.
- To identify risk factors associated with infection in rhinoplasty procedures.
Main Methods:
- Retrospective review of 2630 East Asian rhinoplasty cases (July 2003 - June 2018).
- Analysis of infection incidence based on primary vs. revision surgery and materials used.
- Evaluation of cultured organisms, infection timing, and intervention methods.
Main Results:
- Overall infection rate was 0.84% (22/2630 cases), with 18/22 infections in revision cases.
- Revision surgery carried a 19-fold higher infection rate (3.63%) than primary surgery (0.19%).
- Women had a 3.6-fold higher infection risk; autologous costal cartilage use was associated with 3.39% infection rate.
Conclusions:
- Revision rhinoplasty in women, particularly with costal cartilage or septal perforation repair, shows a higher risk of infection.
- Infections commonly manifest at the nasal tip and caudal septum/columella.
- Surgical débridement was the primary management for most infected cases.
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