Meteorological Influence on Tissue Expander-Related Major Infection

Abstract

ABSTRACT Background Infection is a relevant complication of tissue expander surgery that may compromise the flap. The effects of meteorological variables on surgical site infection have been observed in many surgeries; however, their influence on tissue expander infection is unknown. Methods We identified tissue expander implantation and infection based on their International Classification of Diseases, 10th revision, codes in electronic hospitalization summary reports of 26 cities from January 1, 2014 to December 31, 2015. The data of the present study were collected for administrative purposes without any personal identifiers. The Cox proportional hazard model was used to investigate the association between meteorological variables and tissue expander-related major infection with six covariates. Results A total of 3,089 patients were enrolled. Of them, 8.7% experienced a major infection during the study period. The optimal daily average temperature was between 22.9 °C and 26.8 °C, and the risk of major infection was significantly decreased in this range. The minimal infection temperature was 24.4 °C, with a hazard ratio of 0.85. When the average relative humidity was 37%, the infection risk was minimal with a hazard ratio of 0.86; however, a relative humidity of ≥ 79% significantly increased the risk of infection. Conclusions This is the first study to investigate the impact of temperature and relative humidity on tissue expander-related major infection. Our study suggests that there may be an optimal range of both temperature (22.9 °C–26.8 °C) and relative humidity (