Risk factors for surgical site infection in breast surgery

Aholaakko, Teija-Kaisa; Metsälä, Eija; Sihvonen, Marja; Lyytikäinen, Outi

doi:10.1111/jocn.12009

Cited by 20 publications

(8 citation statements)

References 41 publications

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“…11 Teija-Kaisa et al found that reoperation was an independent risk factor for SSI after BCS, however the type of previous operation was not described. 12 Using data from the National Surgical Quality Improvement Program, de Blacam reported that wound complications (SSI or wound disruption) after BCS were nearly twice as likely when there was a prior (unspecified) operation within 30 days. 19 …”

Section: Discussionmentioning

confidence: 99%

Increased Risk of Surgical Site Infection Among Breast-Conserving Surgery Re-excisions

et al. 2014

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Purpose To determine the risk of surgical site infection (SSI) after primary breast-conserving surgery (BCS) versus re-excision among women with carcinoma in situ or invasive breast cancer. Methods We established a retrospective cohort of women aged 18–64 years with ICD-9-CM procedure or CPT-4 codes for BCS from 6/29/2004–12/31/2010. Prior insurance plan enrollment of at least 180 days was required to establish the index BCS; subsequent re-excisions within 180 days were identified. SSIs occurring 2–90 days after BCS were identified by ICD-9-CM diagnosis codes. The attributable surgery was defined based on SSI onset compared to the BCS date(s). A chi-square test and generalized estimating equations model were used to compare the incidence of SSI after index and re-excision BCS procedures. Results 23,001 women with 28,827 BCS were identified; 23.2% of women had >1 BCS. The incidence of SSI was 1.82% (418/23,001) for the index BCS and 2.44% (142/5,826) for re-excision BCS (p=0.002). The risk of SSI after re-excision remained significantly higher after accounting for multiple procedures within a woman (odds ratio 1.34, 95% confidence interval, 1.07–1.68). Conclusions Surgeons need to be aware of the increased risk of SSI after re-excision BCS compared to the initial procedure. Our results suggest that risk adjustment of SSI rates for re-excision would allow for better comparison of BCS SSI rates between institutions.

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Section: Discussionmentioning

confidence: 99%

Increased Risk of Surgical Site Infection Among Breast-Conserving Surgery Re-excisions

et al. 2014

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“…In addition to contaminated or dirty site of wound, high body mass index, re-operation and use of post-surgical drain increased the infection risk of surgical site infection among lumpectomies and mastectomies patients [9].…”

Section: Introductionmentioning

confidence: 99%

Jordanian Nurses’ Knowledge of Preventing Surgical Site Infections in Acute Care Settings

Qasem¹,

Hweidi²

2017

OJN

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Background: Surgical Site Infection (SSI) is one of the most common healthcare-associated infections, its account for up to 16% of all healthcare-associated infections worldwide. The SSIs can contribute to post-operative morbidity, prolonged recovery, delayed discharge and increasing cost. Nurses' knowledge of the evidence-based recommendations is necessary to provide high-quality nursing care. Aims: To assess the level of Jordanian nurses' knowledge regarding evidence based guidelines for the prevention of SSIs, to describe the relationship between nurses' knowledge and selected sociodemographics, to examine the differences in nurses' knowledge with respect to selected dichotomized variables, and to identify the most significant predictors of Jordanian nurses' knowledge regarding evidence based guidelines for the prevention of SSIs. Design: Cross-sectional design. Sample: Two hundred registered nurses at four targeted hospitals were recruited conveniently. Results: The mean of the total knowledge scores of the sample was 3.28 out of nine (SD = 1.72, range = 0 -7), the median was 3 out of nine. There were a statistically significant correlation between all tested continuous sociodemographics variables and the total knowledge score (p > 0.05). There is a significant difference in nurses' knowledge between those who are attending to special surgical related training course and who are not. The most significant predictors of Jordanian nurses' knowledge were: the number of credit hours attended by nurses for surgical-related training courses and the total years of work experience in nursing. These variables explained 16.7% of variance. Conclusion: The results of this study shed light on the obstacles that hampers the Jordanian nurses' knowledge regarding evidence based guidelines for the prevention of SSIs in acute care settings. However, the successful implementation of infection control measures, particularly SSIs prevention measures, and well-structured continuing education programs are considered as a substantial element that would improve nurses' knowledge.

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“…In agreement, the present study showed that the use of drain in thyroid surgery increased the risk of SSI. The use of drains in other areas with low risk of post-operative infection, such as breast surgery, has also been associated with a higher risk of SSI [ 21 ]. Therefore, the use of drain in routine thyroid surgery should be discouraged.…”

Section: Discussionmentioning

confidence: 99%

A Nested Case–Control Study on the Risk of Surgical Site Infection After Thyroid Surgery

et al. 2018

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IntroductionIt is unclear if antibiotic prophylaxis reduces the risk of surgical site infection (SSI) in thyroid surgery. This study assessed risk factors for SSI and antibiotic prophylaxis in subgroups of patients.Method and designA nested case–control study on patients registered in the Swedish National Register for Endocrine Surgery was performed. Patients with SSI were matched 1:1 by age and gender to controls. Additional information on patients with SSI and controls was queried from attending surgeons using a questionnaire. Risk factors for SSI were evaluated by logistic regression analysis and presented as odds ratio (OR) with 95% confidence interval (CI).ResultsThere were 9494 operations; 109 (1.2%) patients had SSI. Patients with SSI were older (median 53 vs. 49 years) than patients without SSI p = 0.01 and more often had a cancer diagnosis 23 (21.1%) versus 1137 (12.1%) p = 0.01. In the analysis of patients with SSI versus controls, patients with SSI more often had post-operative drainage 68 (62.4%) versus 46 (42.2%) p = 0.01 and lymph node surgery 40 (36.7%) versus 14 (13.0%) p < 0.01, and both were independent risk factors for SSI, drain OR 1.82 (CI 1.04–3.18) and lymph node dissection, OR 3.22 (95% CI 1.32–7.82). A higher number of 26(62%) patients with independent risk factors for SSI and diagnosed with SSI did not receive antibiotic prophylaxis. Data were missing for 8 (31%) patients.ConclusionLymph node dissection and drain are independent risk factors for SSI after thyroidectomy. Antibiotic prophylaxis might be considered in patients with these risk factors.

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Risk factors for surgical site infection in breast surgery

Cited by 20 publications

References 41 publications

Increased Risk of Surgical Site Infection Among Breast-Conserving Surgery Re-excisions

Increased Risk of Surgical Site Infection Among Breast-Conserving Surgery Re-excisions

Jordanian Nurses’ Knowledge of Preventing Surgical Site Infections in Acute Care Settings

A Nested Case–Control Study on the Risk of Surgical Site Infection After Thyroid Surgery

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