title: Application time for postoperative wound dressing following breast augmentation with implants: study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Breast augmentation with silicone implants is one of the most frequently performed cosmetic surgeries worldwide. Surgical site infection (SSI) remains an important complication of this procedure. One of the most important risk factors for SSI is the presence of microorganisms on the skin surrounding the wound. Guidelines by the Centers for Disease Control (CDC) recommend that surgical wounds be covered with a sterile dressing for 24 to 48 hours. However, a recent study showed that the application of a dressing for six days after breast reduction reduced wound colonization by coagulase-negative staphylococci.
  
  
  METHODS
  A randomized clinical trial was designed to assess two protocols of postoperative wound care to determine how the application duration of the postoperative dressing influences wound colonization in patients undergoing breast augmentation with silicone implants. Women aged between 18 and 60 years who are candidates for breast augmentation with silicone implants will be randomly allocated to group I (n = 48), in which the dressing will be removed on the first postoperative day, or group II (n = 48), in which the dressing will be removed on the sixth postoperative day. Cutaneous colonization will be assessed by cultures of samples of skin flora taken from the wound region. The incidence of SSI, using standardized CDC criteria, and the perceptions of patients towards the dressing will be secondary outcomes.
  
  
  CONCLUSIONS
  An important component of SSI prevention is to minimize all possible risk factors, and the application of postoperative dressing plays a key role in this endeavor. The results of this clinical trial may help to standardize postoperative wound care after breast augmentation with silicone implants.
  
  
  BACKGROUND
  This trial was registered on 12 March 2012 with ClinicalTrials.gov (identifier: NCT01553604 ).
authors.affiliation: Division of Plastic Surgery, Universidade Federal de São Paulo, Rua Napoleão de Barros, 715,-4° andar, São Paulo - SP, CEP, 04024-002, Brazil. deniseamendes@uol.com.br.|Division of Plastic Surgery, Department of Surgery, Universidade do Vale do Sapucaí, Avenida Alfredo Custódio de Paula, 320, Pouso Alegre - MG, CEP, 37550-000, Brazil. deniseamendes@uol.com.br.
authors.forename: Denise de Almeida
authors.initials: Dde A
authors.lastname: Mendes
authors.affiliation: Division of Plastic Surgery, Universidade Federal de São Paulo, Rua Napoleão de Barros, 715,-4° andar, São Paulo - SP, CEP, 04024-002, Brazil. danielafveiga@gmail.com.|Division of Plastic Surgery, Department of Surgery, Universidade do Vale do Sapucaí, Avenida Alfredo Custódio de Paula, 320, Pouso Alegre - MG, CEP, 37550-000, Brazil. danielafveiga@gmail.com.
authors.forename: Daniela Francescato
authors.initials: DF
authors.lastname: Veiga
authors.affiliation: Division of Plastic Surgery, Universidade Federal de São Paulo, Rua Napoleão de Barros, 715,-4° andar, São Paulo - SP, CEP, 04024-002, Brazil. veigafilhoj@gmail.com.|Division of Plastic Surgery, Department of Surgery, Universidade do Vale do Sapucaí, Avenida Alfredo Custódio de Paula, 320, Pouso Alegre - MG, CEP, 37550-000, Brazil. veigafilhoj@gmail.com.
authors.forename: Joel
authors.initials: J
authors.lastname: Veiga-Filho
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Universidade do Vale do Sapucaí, Avenida Alfredo Custódio de Paula, 320, Pouso Alegre - MG, CEP, 37550-000, Brazil. femfonseca@uol.com.br.
authors.forename: Fernando Elias Martins
authors.initials: FE
authors.lastname: Fonseca
authors.affiliation: Department of Microbiology, Universidade do Vale do Sapucaí, Avenida Alfredo Custódio de Paula, 320, Pouso Alegre - MG, CEP, 37550-000, Brazil. francisleybiologo@yahoo.com.br.
authors.forename: Luiz Francisley
authors.initials: LF
authors.lastname: de Paiva
authors.affiliation: Department of Bioestatistics, Universidade do Vale do Sapucaí, Avenida Alfredo Custódio de Paula, 320, Pouso Alegre - MG, CEP, 37550-000, Brazil. nnovo@unisa.br.
authors.forename: Neil Ferreira
authors.initials: NF
authors.lastname: Novo
authors.affiliation: Department of Microbiology, Universidade do Vale do Sapucaí, Avenida Alfredo Custódio de Paula, 320, Pouso Alegre - MG, CEP, 37550-000, Brazil. analkimin@hotmail.com.
authors.forename: Ana Beatriz Alkmin Teixeira
authors.initials: AB
authors.lastname: Loyola
authors.affiliation: Division of Plastic Surgery, Universidade Federal de São Paulo, Rua Napoleão de Barros, 715,-4° andar, São Paulo - SP, CEP, 04024-002, Brazil. lydiamferreira@gmail.com.
authors.forename: Lydia Masako
authors.initials: LM
authors.lastname: Ferreira
mesh_terms: D000293:Adolescent; D000328:Adult; D001458:Bandages; D018427:Breast Implants; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D016462:Mammaplasty; D008875:Middle Aged; D013530:Surgical Wound Infection / Q000517:prevention & control*; D013997:Time Factors