The Measurement of Wound Infection after Breast Surgery

Hall, John C.; Hall, Joanne M.

doi:10.1111/j.1075-122x.2004.21401.x

Cited by 11 publications

(11 citation statements)

References 13 publications

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“…There was no statistically significant difference between the two groups. Hall and Hall 23 reported a rate of cellulitis of 11% and a rate of abscesses of 4.6% following breast surgery, a result that was similar to that found in the present study. Therefore, care should be taken to ensure that antisepsis of the surgical area is strictly observed.…”

Section: Discussionsupporting

confidence: 91%

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Complete axillary dissection without drainage for the surgical treatment of breast cancer: a randomized clinical trial

Freitas‐Junior¹,

Ribeiro²,

Moreira³

et al. 2017

Clinics

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OBJECTIVE:This randomized clinical trial evaluated the possibility of not draining the axilla following axillary dissection.METHODS:The study included 240 breast cancer patients who underwent axillary dissection as part of conservative treatment. The patients were divided into two groups depending on whether or not they were subjected to axillary drainage. ClinicalTrials.gov: NCT01267552.RESULTS:The median volume of fluid aspirated was significantly lower in the axillary drainage group (0.00 ml; 0.00 – 270.00) compared to the no drain group (522.50 ml; 130.00 - 1148.75). The median number of aspirations performed during conservative breast cancer treatment was significantly lower in the drainage group (0.5; 0.0 - 4.0) compared to the no drain group (5.0; 3.0 - 7.0). The total volume of serous fluid produced (the volume of fluid obtained from drainage added to the volume of aspirated fluid) was similar in the two groups. Regarding complications, two cases (2.4%) of wound dehiscence occurred in the drainage group compared to 13 cases (13.5%) in the group in which drainage was not performed, with this difference being statistically significant. Rates of infection, necrosis and hematoma were similar in both groups.CONCLUSION:Safety rates were similar in both study groups; hence, axillary dissection can feasibly be performed without drainage. However, more needle aspirations could be required, and there could be more cases of wound dehiscence in patients who do not undergo auxiliary drainage.

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Section: Discussionsupporting

confidence: 91%

“…This complication was strongly influenced by the no drain group, in which the rate was 13.5% versus 2.4% in the drainage group. If we consider only the data from the drainage group, then the rate encountered was similar to rates reported from other previously published studies 1,6,23.…”

Section: Discussionsupporting

confidence: 80%

Complete axillary dissection without drainage for the surgical treatment of breast cancer: a randomized clinical trial

Freitas‐Junior¹,

Ribeiro²,

Moreira³

et al. 2017

Clinics

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“…The variation in reported rates depends on the type of breast operation, definitions used for infection, surveillance methods to identify infections, and length of postoperative follow-up. 4 Using standardized surveillance for one year after surgery, we previously reported SSI rates for specific breast operations at a single institution ranging from 1.1% after reduction mammoplasty, 4.4% after mastectomy, 6.2% after mastectomy with immediate flap reconstruction, to 12.4–16.5% after mastectomy with immediate implant. 5;6 The goal of our study was to determine the incidence of SSI in a large population of women with private health insurance following mastectomy with and without immediate implant or flap reconstruction performed at many different facilities.…”

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confidence: 99%

Incidence of Surgical Site Infection Following Mastectomy With and Without Immediate Reconstruction Using Private Insurer Claims Data

Olsen

Nickel

Fox

et al. 2015

Infect. Control Hosp. Epidemiol.

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Objective The National Healthcare Safety Network classifies breast operations as clean procedures with an expected 1–2% surgical site infection (SSI) incidence. We assessed differences in SSI incidence following mastectomy with and without immediate reconstruction in a large, geographically diverse population. Design Retrospective cohort study. Patients Commercially-insured women aged 18–64 years with ICD-9-CM procedure or CPT-4 codes for mastectomy from 1/1/2004–12/31/2011. Methods Incident SSIs within 180 days after surgery were identified by ICD-9-CM diagnosis codes. The incidence of SSI after mastectomy +/− immediate reconstruction was compared by the chi-square test. Results From 2004–2011, 18,696 mastectomy procedures among 18,085 women were identified, with immediate reconstruction in 10,836 (58%) procedures. The 180-day incidence of SSI following mastectomy with or without reconstruction was 8.1% (1,520/18,696). Forty-nine percent of SSIs were identified within 30 days post-mastectomy, 24.5% between 31–60 days, 10.5% between 61–90 days, and 15.7% between 91–180 days. The incidence of SSI was 5.0% (395/7,860) after mastectomy-only, 10.3% (848/8,217) after mastectomy plus implant, 10.7% (207/1,942) after mastectomy plus flap, and 10.3% (70/677) after mastectomy plus flap and implant (p<0.001). The SSI risk was higher after bilateral compared with unilateral mastectomy with (11.4% vs. 9.4%, p=0.001) and without (6.1% vs. 4.7%, p=0.021) immediate reconstruction. Conclusions SSI incidence was two-fold higher after mastectomy with immediate reconstruction than after mastectomy alone. Only 49% of SSIs were coded within 30 days after operation. Our results suggest stratification by procedure type will facilitate comparison of SSI rates after breast operations between facilities.

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“…The incidence of wound complications after breast cancer surgery ranges from 6 to 30% (Sorenson et al, 2002;Tran et al, 2003;Hall and Hall, 2004) and is increased if there is associated axillary surgery. The aim of this study was to examine the relationship between wound complications and systemic recurrence after excision of primary operable breast cancer.…”

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confidence: 99%

Postoperative wound complications and systemic recurrence in breast cancer

et al. 2007

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Many factors involved in wound healing can stimulate tumour growth in the experimental setting. This study examined the relationship between wound complications and the development of systemic recurrence after treatment of primary breast cancer. One thousand and sixty-five patients diagnosed with operable primary invasive breast cancer between 1994 and 2001 were assessed for development of systemic recurrence according to whether or not a wound complication occurred after surgery, with a median follow-up of 54 months (range 15-119). There were 93 wound complications (9%). There was a statistically significant greater risk of developing systemic recurrence in patients with wound problems than those without (hazard ratio (HR) 2.87; 95% CI: 1.97, 4.18; Po0.0001). This remained in a multivariate analysis after adjustment for case mix variables, including Nottingham Prognostic Index (NPI) and oestrogenprogesterone receptor status (HR: 2.52; 95% CI: 1.69, 3.77; Po0.0001). In the good prognostic NPI group, 4 out of 27 patients (15%) with wound problems vs 11 out of 334 (3%) without wound problems developed systemic recurrence. The corresponding figures were 10 out of 35 (29%) vs 48 out of 412 (12 %) in the moderate prognostic group and 18 out of 29 (62%) vs 75 out of 199 (38%) in the poor prognostic group. In 29 patients NPI could not be calculated. Smokers at the time of diagnosis were more likely to develop metastatic disease than the non-smokers (HR: 1.50; 95% CI: 1.04, 2.15; P ¼ 0.03) after adjustment for other factors. The results suggest that patients with wound complications at primary surgery have increased rates of systemic recurrence of breast cancer.

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The Measurement of Wound Infection after Breast Surgery

Cited by 11 publications

References 13 publications

Complete axillary dissection without drainage for the surgical treatment of breast cancer: a randomized clinical trial

Complete axillary dissection without drainage for the surgical treatment of breast cancer: a randomized clinical trial

Incidence of Surgical Site Infection Following Mastectomy With and Without Immediate Reconstruction Using Private Insurer Claims Data

Postoperative wound complications and systemic recurrence in breast cancer

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