[Incidence and surgical wound infection risk factors in breast cancer surgery].
BACKGROUND
In order to evaluate occurrence and risk factors for wound infection (WI) in breast cancer surgery, we carried out a prospective study.


METHODS
From September 1996 through April 1997, an infection control physician prospectively evaluated 542 wounds of all patients having breast cancer surgery at the Oscar Lambret Cancer Center. WI was defined as a wound with pus. Antibiotic prophylaxis was given in case of immediate breast reconstruction. Statistical evaluation was performed using the c < or = test for categorial data and non-parametric Mann-Whitney test for continuous data. In univariate analysis, differences were considered significant at p < 0.01.


RESULTS
The overall WI rate was 3.51% (19/352). In univariate analysis, risk factors for WI were: total preoperative hospital stay (p = 0.01), previous chemotherapy (p = 0.01), previous oncologic surgery (p = 0.03) and immediate breast reconstruction (p = 0.002). In mutivariate analysis, we observed two independent predictive factors for WI: previous chemotherapy (p = 0.05) and immediate breast reconstruction (p = 0.02).


CONCLUSIONS
Previous anticancer chemotherapy was a major risk factor. In these cases, a phase III trial could confirm efficacy of standard antibiotic prophylaxis. Breast reconstruction was the second major risk factor. Standard antibiotic prophylaxis (used in our study) was insufficient.
Lefebvre
D
D
Comité de Lutte contre les Infections nosocomiales, Centre Oscar Lambret, Lille. d-lefebvre@o-lambret.fr
Penel
N
N
Deberles
M F
MF
Fournier
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D019072:Antibiotic Prophylaxis; D000970:Antineoplastic Agents / Q000009:adverse effects; D001943:Breast Neoplasms / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D017053:Infection Control; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D016462:Mammaplasty / Q000009:adverse effects; D008408:Mastectomy / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology*
D000970:Antineoplastic Agents