Wiser Itay, Plonski Lori, Shimon Nitai, Friedman Tali, Heller Lior
From the Department of Plastic Surgery, Assaf Harofeh Medical Center, Zerifin, Affiliated to the Sackler Faculty of Medicine, and.
Ann Plast Surg. 2019 May;82(5):493-498. doi: 10.1097/SAP.0000000000001819.
Surgical site infections (SSIs) following body-contouring plastic surgery pose a significant burden on patients and caregivers, possibly leading to undesired surgical outcomes. Surgical site infection incidence following body-contouring plastic surgery ranges from 2% to 7%, but is estimated much higher among postbariatric massive weight loss (MWL) patients.
The aim of this study was to evaluate SSI rate, risk and protective factors among postbariatric MWL patients following body-contouring plastic surgery.
This was a nested case-control study of MWL patients who underwent body-contouring plastic surgery at the Department of Plastic Surgery at Assaf Harofeh Medical Center, between 2007 and 2014. Data were obtained from medical records. Surgical site infection was defined according to the Centers for Disease Control and Prevention criteria. Logistic regression was conducted to assess independent risk factors for SSIs.
From a cohort of 172 patients, 86 were included in the study. Surgical site infection rate was 20% (n = 17). Significant SSI risk factors included lifetime maximal weight and lifetime maximal body mass index (P = 0.039 and P = 0.002, respectively), body mass index loss prior to surgery (P = 0.032), estimated blood loss during surgery (P = 0.002), and gynecomastia repair procedure (P = 0.038). Independent SSI-associated factors included thigh lift procedure (odds ratio, 4.66; 95% confidence interval, 1.13-19.28) and preoperative antimicrobial prophylaxis (odds ratio, 0.04; 95% confidence interval, 0.03-0.61).
Although not required by current guidelines for body-contouring plastic surgery, preoperative antimicrobial prophylaxis in our study demonstrated a significant protective effect against SSIs. Further research may reveal its true contribution to SSI prevention in body-contouring plastic surgery.
身体塑形整形手术后的手术部位感染（SSIs）给患者和护理人员带来了沉重负担，可能导致不理想的手术结果。身体塑形整形手术后的手术部位感染发生率在2%至7%之间，但据估计，在减肥后大量体重减轻（MWL）的患者中要高得多。
本研究的目的是评估减肥后MWL患者在身体塑形整形手术后的SSI发生率、风险和保护因素。
这是一项对2007年至2014年间在阿萨夫·哈罗费医疗中心整形外科接受身体塑形整形手术的MWL患者进行的巢式病例对照研究。数据来自医疗记录。手术部位感染根据疾病控制与预防中心的标准进行定义。进行逻辑回归以评估SSIs的独立危险因素。
在172名患者的队列中，86名被纳入研究。手术部位感染率为20%（n = 17）。显著的SSI危险因素包括终生最大体重和终生最大体重指数（分别为P = 0.039和P = 0.002）、手术前的体重指数下降（P = 0.032）、手术期间的估计失血量（P = 0.002）以及男性乳房肥大修复手术（P = 0.038）。与SSI相关的独立因素包括大腿提升手术（比值比，4.66；95%置信区间，1.13 - 19.28）和术前抗菌预防（比值比，0.04；95%置信区间，0.03 - 0.61）。
尽管目前身体塑形整形手术指南未要求，但我们研究中的术前抗菌预防对SSIs显示出显著的保护作用。进一步的研究可能会揭示其在身体塑形整形手术中预防SSI的真正作用。
