Surgical site infections in plastic surgery: an italian multicenter study.
BACKGROUND
Plastic surgery interventions have increased in terms of frequency, complexity of surgical procedures, and postoperative complications, particularly surgical site infections (SSIs). The aim of the present study was to assess the SSI frequency in plastic and reconstructive surgery settings in Italy and to evaluate the associated risk factors.


METHODS
From June 2004 to June 2005, a prospective multicenter study including 2806 consecutive patients was conducted in 23 Italian plastic and reconstructive units. To assess potential risk factors for surgical site infection, a conditional logistic regression model was used and results were exposed in terms of odds ratio (OR) with their respective 95% confidence interval (CI).


RESULTS
SSIs occurred in 85/2806 (3%) patients. Sixty (70.6%), 24 (28.2%), and 1 (1.2%) SSIs were classified as superficial, deep, and organ/space, respectively. Sixty-six percent of the SSIs were diagnosed during postdischarge surveillance. At multivariate analysis, diabetes mellitus, chronic obstructive pulmonary disease, preoperative radiotherapy, and use of surgical drains were significantly associated with the occurrence of SSI.


CONCLUSIONS
Our findings, based on a large population including all types of plastic and reconstructive interventions, provided consistent information on potential risk factors for SSI in this surgical setting. Moreover, the high rate of SSI found during the postdischarge surveillance underlines the need for improving active surveillance methodologies in this surgical setting.
Drapeau
Cecilia M J
CM
National Institute for Infectious Diseases L. Spallanzani, Rome, Italy.
D'Aniello
Carlo
C
Brafa
Anna
A
Nicastri
Emanuele
E
Silvestri
Alessandro
A
Nisi
Giuseppe
G
Petrosillo
Nicola
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019651:Plastic Surgery Procedures / Q000706:statistics & numerical data*; D012307:Risk Factors; D013518:Surgery, Plastic / Q000706:statistics & numerical data*; D013530:Surgical Wound Infection / Q000453:epidemiology*