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Risk Factors For Surgical Site Infection In Breast Reconstruction
Stephanie E. Farber, Rachel Guest, Connor Davenport, Xiao Zhu, Ian Chow, Michael Gimbel
UPMC
2019-02-05
Presenter: Stephanie Farber
Affidavit:
This abstract represents the original work of Dr. Stephanie Farber
Director Name: Vu Nguyen
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Introduction
Infections cause devastating complications in breast reconstruction. National database studies provide information about complication rates within 30 days postoperatively, but our study investigates risk factors for infectious complications at all time points.
Methods
A retrospective study was performed to investigate risk factors for infectious complications in breast reconstruction. Demographic data was collected including age, body mass index (BMI), and past medical and oncologic history. Surgical data was collected including prep solution and type of reconstruction. Univariate and multivariate analyses were performed to determine risk factors for infectious complications.
Results
A total of 507 patients, or 798 breasts, were included in the study. The average age was 48.5±10.4 years and the average BMI was 26.4±5.9 kg/m2. Of these patients, 62.1% underwent prosthetic breast reconstruction, 9.9% underwent pedicled flap reconstruction, and 27.9% underwent free flap reconstruction. 11.4% of patients developed surgical site infections with 3.9% of patients requiring reoperation for these infections. Risk factors for infection on univariate analysis included elevated BMI and history of diabetes (p<0.05). On multivariate analysis, elevated BMI, history of radiation, and free flap-based reconstruction were correlated with infection (p<0.05).
Conclusion
This study aimed to determine risk factors for infectious complications in breast reconstruction. Age, smoking status, and surgical prep solution were not correlated with infection. Higher BMI correlated with an increased risk of infection, as did history of diabetes or radiation. Free flap-based reconstruction was a protective factor. Knowledge of risk factors for subsequent infection may prove valuable in determining approach to pre- and post-operative management.
