title: Determinants of clean surgical wound infections for breast procedures at an oncology center.
abstract: OBJECTIVE
  To determine the clean surgical wound infection rate for breast procedures and the risk factors predisposing patients to these infections.
  
  
  METHODS
  A survey study.
  
  
  METHODS
  Oncology center.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY.
authors.forename: C
authors.initials: C
authors.lastname: Rotstein
authors.forename: R
authors.initials: R
authors.lastname: Ferguson
authors.forename: K M
authors.initials: KM
authors.lastname: Cummings
authors.forename: M R
authors.initials: MR
authors.lastname: Piedmonte
authors.forename: J
authors.initials: J
authors.lastname: Lucey
authors.forename: A
authors.initials: A
authors.lastname: Banish
mesh_terms: D001706:Biopsy; D001943:Breast Neoplasms / Q000601:surgery*; D002277:Carcinoma / Q000601:surgery*; D004322:Drainage; D005260:Female; D006801:Humans; D017053:Infection Control; D007902:Length of Stay; D008408:Mastectomy; D015412:Mastectomy, Segmental; D009518:New York / Q000453:epidemiology; D016522:Oncology Service, Hospital; D011159:Population Surveillance; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000145:classification / Q000453:epidemiology*; D013997:Time Factors