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Risk factors for surgical site infection in breast surgery

Authors

  • Aholaakko Teija-Kaisa MSc, RN, LitEd,

    PhD Candidate, Corresponding author
    • University of Helsinki Medical Faculty, Helsinki and Principal Lecturer, Laurea University of Applied Sciences, Vantaa, Finland
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  • Metsälä Eija PhD,

    Principal Lecturer
    1. Metropolia University of Applied Sciences, Helsinki, Finland
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  • Sihvonen Marja PhD,

    Docent of Primary Health Care
    1. Department of Primary Health Care, University of Helsinki, Helsinki, Finland
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  • Lyytikäinen Outi MD, PhD

    Senior Medical Officer
    1. Department of Infectious Disease, Surveillance and Control, Epidemiologic Surveillance and Response Unit, Finnish Hospital Infection Program (SIRO), National Institute for Health and Welfare (THL), Helsinki, Finland
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Errata

This article is corrected by:

  1. Errata: Erratum Volume 24, Issue 19-20, 3020, Article first published online: 22 September 2015

Correspondence: Aholaakko Teija-Kaisa, Principal Lecturer, Laurea University of Applied Sciences, Ratatie 22, FIN-01300 Vantaa, Finland. Telephone: +358 46 8567 348.

E-mail: teija-kaisa.aholaakko@laurea.fi

Abstract

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.

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