Surgical Site Infection after Breast Surgery: A Retrospective Analysis of 5-Year Postoperative Data from a Single Center in Poland.

Anna Palubicka,Radoslaw Jaworski,Jacek Zielinski,Janusz Jaskiewicz,Michal Pikula,Beata Swieczko-Zurek,Marcin Wekwejt

doi:10.3390/medicina55090512

Abstract

Background and Objectives: Surgical site infection (SSI) is a significant complication of non-reconstructive and reconstructive breast surgery. This study aimed to assess SSI after breast surgery over five years in a single center in Poland. The microorganisms responsible for SSI and their antibiotic susceptibilities were determined. Materials and Methods: Data from 2129 patients acquired over five years postoperatively by the Department of Surgical Oncology, Medical University of Gdansk in Poland were analyzed. Results: SSI was diagnosed in 132 patients (6.2%) and was an early infection in most cases (65.2%). The incidence of SSI was highest in patients who underwent subcutaneous amputation with simultaneous reconstruction using an artificial prosthesis (14.6%), and breast reconstruction via the transverse rectus abdominis muscle (TRAM) flap method (14.3%). Gram-positive bacteria were responsible for SSI in most cases (72.1%), and these were mainly Staphylococcus strains (53.6%). These strains were 100% susceptible to all beta-lactam antibiotics (except penicillin) but were less susceptible to macrolides and lincosamides. Conclusions: SSI is a serious problem, and attention should be focused on its prevention. Reconstruction using an artificial prosthesis or via the TRAM flap method is connected to increased SSI incidence. Further studies are required to prevent SSI following breast surgery.

Highlights

Surgical site infection (SSI) is one of the most common and serious complications following surgery
Breast-conserving surgery, breast reconstruction via the transverse rectus abdominis muscle (TRAM) flap method, and subcutaneous amputation with simultaneous reconstruction using an artificial prosthesis were performed in 40%, 47%, 3%, and 10% of the sampled patients, respectively
This study investigated the occurrence of SSI in patients who underwent breast surgery in a single surgical oncology center in northern Poland

Summary

Introduction

Surgical site infection (SSI) is one of the most common and serious complications following surgery. The occurrence of SSI varies according to the type of operation, wound cleanliness, and the operative field. This complication can lead to prolonged hospitalization, which increases the cost of treatment [1,2,3]. The risk of complications, including SSI, is affected by the type of breast surgery and whether breast reconstruction is performed. Surgical site infection (SSI) is a significant complication of non-reconstructive and reconstructive breast surgery. The incidence of SSI was highest in patients who underwent subcutaneous amputation with simultaneous reconstruction using an artificial prosthesis (14.6%), and breast reconstruction via the transverse rectus abdominis muscle (TRAM) flap method (14.3%)

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