Kaoutzanis Christodoulos, Gupta Varun, Winocour Julian, Shack Bruce, Grotting James C, Higdon Kent
Drs Kaoutzanis and Winocour are Plastic Surgery Fellows, Drs Gupta and Higdon are Assistant Professors, and Dr Shack is a Professor and Chairman, Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN. Dr Grotting is a Clinical Professor, Division of Plastic Surgery, University of Alabama, Birmingham, AL; and CME/MOC Section Editor for Aesthetic Surgery Journal
Drs Kaoutzanis and Winocour are Plastic Surgery Fellows, Drs Gupta and Higdon are Assistant Professors, and Dr Shack is a Professor and Chairman, Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN. Dr Grotting is a Clinical Professor, Division of Plastic Surgery, University of Alabama, Birmingham, AL; and CME/MOC Section Editor for Aesthetic Surgery Journal.
Aesthet Surg J. 2017 Jan;37(1):89-99. doi: 10.1093/asj/sjw100. Epub 2016 Sep 30.
Surgical site infections (SSIs) represent one of the most common postoperative complications in patients undergoing aesthetic surgery.
This study reports the incidence and risk factors of major SSIs following aesthetic surgery.
A prospective cohort of patients who underwent aesthetic surgery between 2008 and 2013 was identified from the CosmetAssure database. Primary outcome was occurrence of a major SSI requiring emergency room visit, hospital admission, or reoperation within 30 days of the index operation. Univariate and multivariate analysis evaluated potential risk factors for SSIs including age, gender, body mass index (BMI), smoking, diabetes, type of surgical facility, procedure by body region, and combined procedures.
A total of 129,007 patients were identified, of which 599 (0.46%) had a major SSI. Mean age (43.8 ± 12.4 years vs 40.9 ± 13.9 years, P < .01) and BMI (27.3 ± 5.5 kg/m vs 24.3 ± 4.6 kg/m, P < .01) were higher in patients with SSIs. Patients with a SSI were more likely to be smokers (10.5% vs 8.2%, P = .04) and diabetic (4.5% vs 1.8%, P < .01). Females suffered more SSI than males (0.5% vs 0.3%, P = .02). Trunk/extremity procedures had a higher incidence of SSI compared to breast or face procedures (0.9% vs 0.2%, P < .01). On multivariate analysis, independent predictors of SSI included age (Relative Risk [RR] 1.01), female gender (RR 1.86), BMI (RR 1.07), smoking (RR 1.61), diabetes (RR 1.58), hospital or ambulatory surgery center procedures (RR 1.39), trunk/extremity procedures (RR 2.42), and combined procedures (RR 1.88).
SSIs following cosmetic surgical procedures are associated with numerous independent predictors, which should be taken into consideration when counseling patients undergoing aesthetic surgery.
2 Risk.
手术部位感染（SSIs）是接受美容手术患者最常见的术后并发症之一。
本研究报告美容手术后严重SSIs的发生率及危险因素。
从CosmetAssure数据库中确定2008年至2013年间接受美容手术的前瞻性队列患者。主要结局是在初次手术后30天内发生需要急诊就诊、住院或再次手术的严重SSI。单因素和多因素分析评估了SSIs的潜在危险因素，包括年龄、性别、体重指数（BMI）、吸烟、糖尿病、手术机构类型、按身体部位的手术方式以及联合手术。
共识别出129,007例患者，其中599例（0.46%）发生严重SSI。SSI患者的平均年龄（43.8±12.4岁对40.9±13.9岁，P<.01）和BMI（27.3±5.5kg/m对24.3±4.6kg/m，P<.01）较高。SSI患者更可能是吸烟者（10.5%对8.2%，P=.04）和糖尿病患者（4.5%对1.8%，P<.01）。女性发生SSI的比例高于男性（0.5%对0.3%，P=.02）。与乳房或面部手术相比，躯干/四肢手术的SSI发生率更高（0.9%对0.2%，P<.01）。多因素分析显示，SSI的独立预测因素包括年龄（相对风险[RR]1.01）、女性性别（RR 1.86）、BMI（RR 1.07）、吸烟（RR 1.61）、糖尿病（RR 1.58）、医院或门诊手术中心手术（RR 1.39）、躯干/四肢手术（RR 2.42）以及联合手术（RR 1.88）。
美容手术后的SSIs与众多独立预测因素相关，在为接受美容手术的患者提供咨询时应予以考虑。
2级风险。
