Methicillin-resistant Staphylococcus aureus--positive surgical site infections in face-lift surgery.
OBJECTIVE
To determine the incidence of methicillin-resistant Staphylococcus aureus (MRSA)-positive surgical site infections after face-lift surgery and to discuss the screening, prevention, and treatment of such infections.


METHODS
The patient charts of 780 patients who underwent a deep-plane rhytidectomy between 2001 and 2007 were reviewed for postoperative wound infections. Culture results and sensitivities were recorded. To our knowledge, this is the first study that documents MRSA-positive surgical site infections after face-lift surgery.


RESULTS
Five of 780 patients (0.6%) who underwent face-lift surgery by the senior surgeon had postoperative surgical site infections. Four of the 5 patients had cultures that were positive for MRSA. Two of these patients (0.3%) required hospitalization and had collections that had to be opened or drained and developed wound breakdown. Both patients eventually responded to wound care along with intravenous and then oral antibiotic therapy. The other 2 MRSA-infected patients responded to oral antibiotic therapy and local wound care alone. The 2 complicated infections occurred on postoperative days 5 and 8. These 2 patients were the only ones among the 5 patients with positive cultures who had known recent contact with another physician or a hospital. All infections occurred in the year 2006, with 3 patients experiencing infection in the last 4 months of the year. Herein, we describe the incidence and sequelae of MRSA infections and colonization. The 2 major different subsets of MRSA are community-acquired MRSA and health care-associated MRSA. Surgical site infections that are positive for MRSA blur this division, which affects many aspects of the course of disease and treatment. We also discuss strategies for screening, preventing, and treating MRSA surgical site infections.


CONCLUSIONS
Methicillin-resistant S aureus-positive surgical site infection is an increasingly problematic issue in all surgical fields. In the future, MRSA-positive infections will be more prevalent and will require well-developed screening, prevention, and treatment strategies.
Zoumalan
Richard A
RA
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Lennox Hill-Manhattan Eye, Ear, and Throat Hospital, NY, NY, USA.
Rosenberg
David B
DB
D000368:Aged; D005260:Female; D006801:Humans; D016106:Methicillin Resistance; D008875:Middle Aged; D015361:Rhytidoplasty / Q000009:adverse effects*; D013203:Staphylococcal Infections / Q000209:etiology / Q000382:microbiology* / Q000517:prevention & control / Q000628:therapy; D013211:Staphylococcus aureus / Q000187:drug effects*; D013530:Surgical Wound Infection / Q000382:microbiology* / Q000517:prevention & control / Q000628:therapy