Zentralbl Gynakol 2002; 124(8/9): 429-433
DOI: 10.1055/s-2002-38129
Original article

© Georg Thieme Verlag Stuttgart · New York

Determinants of Wound Infections After Surgery for Breast Cancer

Determinanten von Wundinfektionen nach MastektomieA. Nieto1 , M. Lozano1 , M. T. Moro 1 , J. Keller1 , C. Carralafuente1
  • 1Servicio de Obstetricia y Ginecología. Hospital Universitario Principe de Asturias. Departamento de Especialidades Médicas. Universidad de Alcalá. Madrid. Spain
Further Information

Publication History

Publication Date:
24 March 2003 (online)

Abstract

Background: There are evident risks factors stemming from any the local post-surgical infection, which merits analysis of morbidity derived from conservative and radical surgery after treatment of the operable breast cancer.

Study Design: 107 patients with breast cancer recruited between November 1995 and October 1997 were evaluated. From that total, 36 patients were subjected to quadrantectomy, axillary lymphadenectomy and postoperative radiation while 71 patients were subjected to modified radical mastectomy.

Results: 7 % percent of patients who underwent modified radical surgery succumbed to postoperative local infection vs. 17 % of patients subjected to breast conserving therapies. Local infections were associated with the older patients (63 vs. 54 years old, p=0.03) and greater obesity (p=0.04). Upon logistic regression analysis conservative surgery exhibited adjusted Odds Ratio of 6.42 (1.27-32.28), p =0.02. In postoperative infection group average hospital stay increased by 6 days (p= 0.0001).

Conclusion: In the present study main risk factors associated with postsurgical wound infection after breast cancer treatment proved to be advanced age, greater obesity and conservative surgery. Nonetheless, more studies are necessary to confirm current findings.

References

  • 1 Veronesi U, Saccozzi M, Del Vecchio M. Comparing radical mastectomy with quadrantectomy, axillary dissection and radiotherapy in patients with small cancers of the breast.  N Engl J Med. 1981;  305 6-11
  • 2 Sarrazin D, Dewae J A, Arriagada R. Conservative management of breast cancer.  Br J Surg. 1986;  73 604-606
  • 3 Fischer B, Redmond C, Poisson R, Margolese R, Womark N, Wickkershman L. Eight year results of a randomized clinical trial comparing mastectomy and lumpectomy with or without irradiation in the treatment of breast cancer.  N Engl J Med. 1989;  320 822-828
  • 4 Veronesi U, Salvadori B, Luini A. Conservative treatment of early breast cancer: long-term results of 1 232 cases treated with quadrantectomy, axillary dissection and radiotherapy.  Ann Surg. 1990;  211 250-259
  • 5 Maskarinec G, Dhakal S, Yamashiro G, Issell B. The use of breast conserving surgery: linking insurance Claim with tumor registry data.  BMC Cancer. 2002;  2 3
  • 6 Vinton A L, Traverso L W, Jolly P C. Wound complications alter modified radical mastectomy compared to tylectomy with axillary lymph node dissection.  Am J Surg. 1991;  161 584-588
  • 7 DeFeiter P W, Stockmann H B, Wereldsma J C, VanPutten W L, VanAssendelft P J. Wound infections alter mastectomy for breast cancer.  The Breast. 1997;  6 6-11
  • 8 Rotstein C, Ferguson R, Cummings K M, Piedmonte M R, Lucey J, Banish A. Determinants of clean surgical wound infections for breast procedures at an oncology Center.  Infect Control Hosp Epidemiol. 1992;  13 207-214
  • 9 Siegel B M, Mayzel K A, Love S M. Level I and II axillary dissection in the treatment of early-stage breast cancer, an analysis of 259 consecutive patients.  Arch Surg. 1990;  125 1144-1147
  • 10 Wedgwood K R, Benson E A. Non-tumor morbidity and mortality after modified radical mastectomy, Ann.  R Coll Surg Engl. 1992;  74 314-317
  • 11 Funnell I C, Crowe P J, Dent D M. a Does surgical experience influence mastectomy complications?.  Ann R Coll Surg Engl. 1992;  74 178-180
  • 12 Platt R, Zucker J R, Zaleznik D F. Perioperative antibiotic prophylaxis and wound infection following breast surgery.  J Antimicrobiol Chemoth. 1992;  31 43-48
  • 13 Lefebvre D, Penel N, Deberles M F, Fournier C. Incidence and surgical infection risk factors in breast cancer surgery.  Press Med. 2000;  29 1937-1932
  • 14 Strozzo M D. An overview of surgical management of stage I and stage II breast cancer ihr the primary rare provider.  Lipincotts Prior Gare Pract. 1998;  2 160-169
  • 15 Lipshy K A, Neifield J P, Boyle R M, Frable W J, Ronan S, Lotfi P, Bea HD, Horsley JS 3 rd, Lawrence W Jr. Complications of mastectomy and their relationship to biopsy technique.  Ann Surg Oncol. 1996;  3 290-294
  • 16 Bardon D W. Principles of antimicrobial prophylaxis.  World J Surg. 1982;  6 262-267
  • 17 Cruse P JE, Foord R N. The epidemiology of wound infection: a 10-year prospective study of 62 939 wounds.  Sarg Clin North Am. 1980;  60 27-40
  • 18 Barber G R, Miransky J, Brown A E, Coit D G, Lewis F M, Thaler H T, Kiehn T E, Armstrong D. Direct observations of surgical wound infections at a comprehensive cancer center.  Arch Surg. 1995;  130 1042-1047
  • 19 Brote L. Wound infections in clean and potentially contaminated surgery: importance of bacterial and non- bacterial factors.  Acta Chic Scand. 1976;  142 91-200
  • 20 Tejler G, Aspegren K. Complications and hospital stay after surgery for breast cancer: a prospective study of 38-5 patients.  Br J Sarg. 1985;  72 542-544

Dr. Anibal Nieto Díaz

C/Toledo No. 2

28804 Alcalá de Henares, Madrid

Fax: (34) 9 18 82 81 01

Email: Anibalnieto@terra.es

    >