Department of surgery, Chittaranjan National Cancer Institute (CNCI), Kolkata-26, India.
Int J Surg. 2009 Dec;7(6):543-6. doi: 10.1016/j.ijsu.2009.08.012. Epub 2009 Sep 10.
Wound infection remains a major source of postoperative morbidity leading to prolonged hospital stays and increased total cost, including indirect expenses related to the wound infection. We examined whether there is any higher risk of wound infection in patients undergo a reoperation after an initial operation or excision/incision biopsy.
A retrospective review of medical charts of patients with breast operations between January 1990 and July 2008 was carried out. The overall incidence of wound infection was 18.2% (231/1267). The rate of wound infection was (32%) when reoperation was done after previous modified radical mastectomy, 18.9% and 16.8% when the previous operations were lumpectomy/segmenectomy with axillary dissection and simple mastectomy without axillary dissection, respectively and (10.8%) when reoperation was performed after previous biopsy. Reoperation involving axillary dissection was associated with significantly higher rates of wound infection (p<0.01). Antibiotic prophylaxis continued into the postoperative period was associated with significantly decreased rate of wound infection (p<0.01).
Initial procedure affects the risk of wound infection in subsequent operation in patients with breast cancer. Significantly higher risks of wound infection are seen in those patients who had undergone axillary dissection or modified radical mastectomy.
伤口感染仍然是导致术后发病率升高的主要原因，导致住院时间延长和总费用增加，包括与伤口感染相关的间接费用。我们研究了初次手术后或切除/切开活检后再次手术的患者是否存在更高的伤口感染风险。
对 1990 年 1 月至 2008 年 7 月间进行的乳腺手术患者的病历进行了回顾性分析。总的伤口感染发生率为 18.2%（231/1267）。在先前的改良根治性乳房切除术之后再次手术时，伤口感染的发生率为 32%，而在先前的手术为保乳术/部分切除术加腋窝清扫术和单纯乳房切除术无腋窝清扫术时，感染率分别为 18.9%和 16.8%，而在先前的活检后再次手术时，感染率为 10.8%。涉及腋窝清扫术的再次手术与更高的伤口感染率显著相关（p<0.01）。在术后继续使用抗生素预防与伤口感染率显著降低相关（p<0.01）。
初始手术会影响乳腺癌患者后续手术中伤口感染的风险。在那些接受过腋窝清扫术或改良根治性乳房切除术的患者中，伤口感染的风险显著增加。
