Rotstein C, Ferguson R, Cummings K M, Piedmonte M R, Lucey J, Banish A
Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY.
Infect Control Hosp Epidemiol. 1992 Apr;13(4):207-14. doi: 10.1086/646511.
To determine the clean surgical wound infection rate for breast procedures and the risk factors predisposing patients to these infections.
A survey study.
Oncology center.
A consecutive sample of adult female patients who underwent surgical breast procedures for suspected carcinoma of the breast. Patients undergoing excisional biopsy, lumpectomy, or mastectomy from January 1985 to January 1987 were included in the study.
Clean surgical wound infection rates were derived overall and for each procedure type. The medical records of all patients were then reviewed to extract data on patient characteristics and operative information in order to assess the risk factors for infection.
Among the breast procedures performed on 448 patients, the overall clean surgical wound infection rate was 8.7% (39/448). The clean surgical wound infection rate for each procedure type was as follows: biopsy 2.3%, lumpectomy 6.6%, and mastectomy 19%. In addition to the type of procedure, factors significantly (p less than .05) associated with the development of clean surgical wound infection in the univariate analysis included: presence of surgical drains (p less than .01); closed suction drainage (odds ratio [OR] = 16.5, 95% confidence interval [CI95] = 5.0-54.7); location of the drain (OR = 3.3, CI95 = 1.7-6.6); prolonged preoperative stay (OR = 1.2, CI95 = 1.0-1.5); length of surgery (OR = 2.2, CI95 = 1.7-3.0); and greater mean age (OR = 1.6, CI95 = 1.2-2.1).
Clean surgical wound infections are not uncommon in patients undergoing breast procedures. Factors relating to both the patient and operative techniques contribute to the clean surgical wound infection rate. Further consideration should be given to perioperative antibiotic prophylaxis for selected breast procedures, and the role of surgical drains should be reassessed.
确定乳房手术的清洁手术切口感染率以及使患者易发生这些感染的危险因素。
一项调查研究。
肿瘤中心。
连续选取的成年女性患者样本，她们因疑似乳腺癌接受了乳房手术。纳入了1985年1月至1987年1月期间接受切除活检、肿块切除术或乳房切除术的患者。
得出总体以及每种手术类型的清洁手术切口感染率。然后查阅所有患者的病历，提取有关患者特征和手术信息的数据，以评估感染的危险因素。
在448例患者接受的乳房手术中，总体清洁手术切口感染率为8.7%（39/448）。每种手术类型的清洁手术切口感染率如下：活检2.3%，肿块切除术6.6%，乳房切除术19%。在单因素分析中，除手术类型外，与清洁手术切口感染发生显著相关（p<0.05）的因素包括：存在手术引流管（p<0.01）；闭式吸引引流（优势比[OR]=16.5，95%置信区间[CI95]=5.0-54.7）；引流管位置（OR=3.3，CI95=1.7-6.6）；术前住院时间延长（OR=1.2，CI95=1.0-1.5）；手术时间（OR=2.2，CI95=1.7-3.0）；以及平均年龄较大（OR=1.6，CI95=1.2-2.1）。
接受乳房手术的患者中，清洁手术切口感染并不少见。与患者和手术技术相关的因素均对清洁手术切口感染率有影响。对于某些乳房手术，应进一步考虑围手术期抗生素预防，并且应重新评估手术引流管的作用。
